Coverage Gap Subsidy Processing Tool

The Coverage Gap Subsidy Processing Tool is designed to capture, store and organize prescription drug event (PDE) data, as well as to process invoices for coverage gap subsidy (CGS) costs incurred by Medicare Part D providers. This data warehouse also serves as a financial recordkeeping system to validate, track and store invoices from PDPs. It also has the ability to verify that the per member annual benefit limits are not exceeded.

The Structured Query Language (SQL) based reporting capabilities offer limitless customized reporting options, such as:

• Financial summaries by member or provider
• Member claim submission history
• Plan to plan benefit reconciliation.

In addition, The Coverage Gap Subsidy Processing Tool can be linked to other databases for eligibility verification.