Viewing Files Included in the Non Coverage Gap Submission

Select additional files

The Select Additional Files section allows the Analyst to add files to the Submission. At any point in time, after a Submission is created, the Analyst can select and add more files to it.

In a similar process, like adding files to a Submission when creating a new Submission, the Analyst can add additional files from the Local System or Disk File System and assign the Mapping Set, Medical Benefit Rule Set etc.., to the additional file. See the File Selection section in the Adding a New Submission documentation for more information.

Uploaded files

The Uploaded files table lists all the added files within the Submission.

On the Uploaded files table, the Analyst can change the following column's information for any uploaded files:

• Medical Benefit: Alter the Medical Benefit toggle selection (From Yes to No and vice versa).

  • When you alter the Medical Benefit toggle from No to Yes, you must specify the Medical Benefit Rule Set.

  • When you alter the Medical Benefit toggle from No to Yes, the previously selected Medical Benefit Rule Set name will be removed.

• Mapping Set: Change the assigned Mapping Set. 

Note: If the Medical Benefit and Mapping set has been updated, the file will be re-imported when the Analyst saves the changes done uploaded files.

• Send For 340B Eval: Alter the Send For 340B Evaluation selection (From Yes to No and vice versa).

Note: The Analyst can change the Send value for 340B Evaluation toggle from Yes (default value) to No and vice versa until the 340B Processing status remains pending or empty. The toggle becomes read-only when the file has been sent for the 340B evaluation (i.e., the 340B Transmission Date has a valid value, and 340B Transmission Status is not Pending. 

Note: The options in the Uploaded files table work similarly to the Included files table when creating a new Submission. The Validation can update/modify uploaded file information for one or more selected files.  The Analyst can also delete the selected files uploaded during the Submission creation. For more information, see the Included Files section in the Adding a New Submission documentation.

The Save button is enabled on the page when the user changes any file details in the Uploaded file table. Click the Save button to save the changes made. A confirmation message is displayed:

On the Uploaded file table, the Analyst can view the following details for the uploaded files:

• File Name: The Name of the utilization file.

• File ID: Unique system assigned ID to the file.

• Include Date: The date and time the utilization file was included in the Submission.

• Size: The size of the respective utilization file.

• Date Received: The date when the utilization file was received.

• Submitted Source ID Type: The ID type of the submitting entity submitted the file. This value is obtained from the file header or trailer.

• Submitted Source ID: The ID of the trading partner submitting the data, often the Contract Entity, for example, HIN or DEA. This value is obtained from the file header or trailer.

• Data Provider ID Qualifier: The organization dispensing the Products in the file, usually a pharmacy, but can be another entity, such as NABP.  This value is obtained from the file header or trailer.

• Data Provider ID Code: The ID of the provider, typically a pharmacy-specific number. This value is obtained from the file header or trailer.

• Grand Total Requested Amount: The total amount requested. This value is obtained from the file trailer.

• Grand Total Scripts: The total scripts from the file. This value is obtained from the file header or trailer.

• Grand Total Quantity: The total quantity from the file. This value is obtained from the file header or trailer.

• Lines Archived: The number of items in the utilization file that were successfully archived. If this field is included in the file, it displays 0 value if the file is not included in an archive session.

• Lines Not Archived: The number of items in the utilization file that were not archived in the last archive session. This field displays 0 for the files that have never been processed in an archive session.

• Type of Validation: The Type of Validation selected for the file to run validation.

• Validation Set and Version: The Validation Set and its version selected for the file to run validation.

Note:
When creating the Submission, if the Start running validation automatically has been set to Yes and Validation details are specified, the value for the Type of Validation and Validation Set and Version column will be pre-populated in the Uploaded file table.

When creating the Submission, if the Start running validation automatically has been set to No, the value for the Type of Validation and Validation Set and Version column remains empty. Once the validation is run and completed successfully, these two fields' values will be populated.

• 340B Transmission Date: Displays the date the file was transmitted for 340B Evaluation. The system updates this column based on the user input set for the 'Send for 340B Evaluation' toggle.
  • When the Send for 340B Evaluation toggle is set to No, the system displays the 340B Transmission Date column value as 'null'.
  • When the Send for 340B Evaluation toggle is set to Yes and the 340B Transmission Status value is New/Pending/Processing or In-Progress, the system displays the 340B Transmission Date column value as 'null'.
  • When the Send for 340B Evaluation toggle is set to Yes and the 340B Transmission Status value is ‘Successful’, the system displays the transaction file transmission date for the 340B Transmission Date column. 
• 340B Transmission Status: Displays the file's current 340B Transmission status. The system updates this column based on the user input set for the 'Send for 340B Evaluation' toggle.
  • When the 340B Evaluation toggle is set to Yes, one of the following values for the 340B Transmission Status:
    • Pending: The File is marked to be sent for 340B Risk Assessment processing.
    • Processing: The system is currently sending or receiving 340B Risk Assessment data.
    • In-Progress: Data is undergoing the assessment process (Externally).
    • Completed: Relevant 340B results have been received for the opted-in files.
  • When the 340B Evaluation toggle is set to Yes, and the file transmission is completed, the system displays the 340B Transmission Status as Completed.
  • When the Send for 340B Evaluation toggle is set to No, the system displays the 340B Transmission Status column value as 'null'.
• 340B Response Date: Specifies the date when the 340B duplicate Discount response is available in the Validata for the file.

Notes: Only those pharmaceutical manufacturers that have explicitly licensed the new  340B Vigilance Validata sub-module will have access to the capabilities pertaining to the 340B Vigilance module. 

• Contains Reversal: Specifies whether the file contains Reversals.

  • An empty value is displayed when the file does not contain reversals.

  • A tick icon is displayed when the file contains reversals.

• Caused Reversal: Specifies whether the file caused Reversals.

  • An empty value is displayed when the file does not cause reversals.

  • A tick icon is displayed when the file causes reversals.

After reviewing the file details, the Analyst can navigate to the Line Level Details tab to view all the uploaded line details.