이 에피소드에 관해
340B claims-level data is the patient- and claim-level information covered entities must reconcile across split billing, contract pharmacy, TPAs, EHR outputs, and wholesaler feeds to defend eligibility and program performance. Bryan McCormick explains that most organizations do not have one source of truth, because retail partner mandates can force multiple TPAs, split billing and contract pharmacy remain separate operational worlds, and compliance accountability still rests with the covered entity even when vendors process claims.
340B Pulse is a NorthArc Health podcast powered by PureLogics, built for operator-level conversations about how the 340B program actually runs day to day.
In this episode, host Muhammad Atif is joined by Bryan McCormick, Corporate Director of the 340B Program at RWJBarnabas Health. Bryan unpacks claims-level data challenges across pharmacy and medical-related 340B workflows, including TPA configuration accountability, multi-TPA aggregation burden, split billing versus contract pharmacy separation, garbage-in/garage-out feed discipline, EHR governance, real-world connectivity failures, reconciliation and root-cause expectations, staffing realities for safety-net hospitals, manufacturer portal fragmentation (ESP and related channels), and a practical view of AI and vendor sprawl.
If your organization needs stronger claims validation, reporting visibility, and custom agentic automation with compliance guardrails, NorthArc Health helps covered entities modernize 340B operations without losing operator control.
0:00:00 TPA configuration is a covered-entity compliance decision
0:01:08 Multi-TPA reality: Walgreens, CVS, and aggregation burden
0:03:25 Why leadership reports must be 100% accurate
0:04:18 Pharmacy vs medical claims fragmentation in 340B
0:04:38 Split billing vs contract pharmacy: two separate worlds
0:07:15 Garbage in, garbage out and roster discipline
0:09:27 PBMs, TPAs, EHR: volume, variability, and fragmentation
0:10:20 Stakeholder forums and EHR as source of truth
0:12:19 Compliance accountability always on the covered entity
0:13:30 Where data breakdowns occur in handoffs
0:14:21 Pharmacy switch outage case (2024 backlog impact)
0:16:21 Operational impact on eligibility, accumulation, and reporting
0:17:33 Monitoring volume and vendor value
0:19:57 Identification, tracking, and read-only access
0:21:21 Reconciliation, escalation, and self-disclosure thresholds
0:23:29 Scaling, Epic + Verity integration, and KISS operations
0:27:19 Dedicated 340B FTEs and policy volatility
0:28:34 Manufacturer portals: ESP, restrictions, no global playbook
0:30:09 Human review before external manufacturer submissions
0:31:27 AI potential vs integration and PHI risk
0:33:22 More vendors means more integration to police
0:34:36 Practical advice: plug-and-play is over
0:38:05 Stakeholder meetings and how to connect with Bryan
What is 340B claims-level data?
340B claims-level data is the detailed claim, eligibility, and feed information covered entities use to run split billing and contract pharmacy workflows, validate vendor outputs, and support compliance, financial reporting, and audit defensibility.
Why do covered entities use multiple TPAs?
Covered entities often use multiple TPAs because major retail contract pharmacy partners may require their own systems while a primary TPA still supports split billing and other contract relationships, which forces manual aggregation before holistic reporting.
Who owns 340B data accuracy when vendors process claims?
The covered entity owns compliance and performance accountability in most vendor relationships, which means teams must validate what they send to TPAs and what vendors return before leadership or external reporting.
#340B program,#claims data, #pharmacy operations, #healthcare compliance, #split billing,#contract pharmacy, #TPA, #EHR integration, #healthcare data
