ESP / Beacon Readiness Review
A practical readiness review to help your team prepare for evolving rebate-era submission pathways — with clear SOP guidance, gap findings, and a defensible checklist.
Consulting-first and platform-optional. We work alongside your TPA and existing systems.
No PHI required. Scope-based support. Clear deliverables.
Readiness that’s operational — not theoretical
The Readiness Review examines the workflows, inputs, documentation, and handoffs that determine whether submission and tracking processes run cleanly. We identify gaps, clarify responsibilities, and provide a practical checklist your team can execute.
Teams facing new submission requirements
When processes are shifting and you need a stable way to respond without chaos.
Lean programs with high dependency on partners
When TPAs, contract pharmacies, and internal teams need clearer handoffs and ownership.
Organizations that want audit-minded controls
When you want repeatability, documented SOPs, and fewer preventable errors.
We strengthen readiness while staying compatible with your current partners and tools.
What we review
We focus on the operational building blocks that make submissions and tracking reliable as requirements evolve.
Data intake & file readiness
Where data comes from, how it’s validated, and where breakpoints occur.
Workflow handoffs & ownership
Who owns each step across internal teams, contract pharmacies, and TPAs.
Identifier and mapping hygiene (process-level)
How identifiers are maintained and checked to reduce preventable mismatches.
Exception handling & rework loops
How rejects/alerts are routed, resolved, documented, and prevented from repeating.
Documentation & SOP coverage
Whether SOPs exist, are current, and reflect real operations.
Tracking & reconciliation posture
How your team confirms completion and keeps evidence trails.
We review processes and controls. We do not require patient-level information.
Common failure points — and the
checklist that prevents them
Most readiness issues are operational: unclear handoffs, inconsistent inputs, and missing documentation. This section turns common breakdowns into a practical checklist.
Common failure points
1- Unclear handoffs between partners
Work “falls between chairs” when ownership isn’t explicit.
2- Inconsistent input formats and validations
Small inconsistencies create preventable rejects and rework.
3- Identifier mapping drift over time
Mappings change, but controls don’t—causing silent breakage.
4- Exception queues without a repeatable playbook
Teams fix issues ad hoc, but the same errors return.
5- SOPs that don’t match reality
Documentation exists but doesn’t reflect current operations.
6- Tracking without a defensible evidence trail
Work gets done, but proof and audit artifacts aren’t consistently captured.
Readiness checklist
- We can describe the end-to-end workflow (who does what, when).
- We have defined owners for intake, validation, submission, and follow-up.
- Input files/data are validated before entering the workflow.
- Known mapping/identifier dependencies are documented and reviewed periodically.
- Exception handling has a clear queue, SLA, and escalation path.
- Rework patterns are tracked (top repeat issues and fixes).
- SOPs exist for critical steps and match current reality.
- Changes are logged (what changed, who approved, when effective).
- Submission status is tracked to completion (not “sent = done”).
- Reconciliation expectations are defined (what “done” means).
- Evidence artifacts are saved in a repeatable structure.
- The process still works if a partner changes (TPA/tool transitions).
This checklist becomes part of your operating playbook and can be reused quarterly.
What you receive
You’ll receive a practical readiness package your team can execute and reuse.
Deliverables
Gap findings + priority list
What’s missing, why it matters, and what to fix first.
Readiness checklist (finalized)
A reusable checklist tailored to your partner model and workflows.
SOP/control guidance (as applicable)
Updates, templates, or recommendations to make processes repeatable.
Exception handling playbook (high-level)
How to route, resolve, document, and reduce repeat issues.
Debrief session + next-step recommendations
Stakeholder alignment and a path forward.
Deliverables are scoped to your program size, data availability, and partner model.
How it works
Typical timeline: 2–4 weeks (varies by complexity and input readiness)
Kickoff & scope alignment
Intake (docs + workflow context; no PHI)
Review (handoffs, controls, exception handling, documentation)
Findings + checklist + action plan
Debrief + next steps
Inputs we need
- High-level workflow overview (even informal)
- Existing SOPs/policies (if available)
- Partner/tool landscape (TPA, pharmacies, systems)
- Example templates/specs (no PHI)
- Known pain points and repeat exceptions