The startup offers a medicine management platform that analyzes drug discount programs through cloud-based data management and customizable insights. Its features include claims verification, dispute resolution, and discount monitoring, providing clients with a streamlined process for effective communication and payment verification.
Funding
$95.5M raised to dateRaised to date based on public sources. This may differ from the amount the company actually raised and is based only on what is publicly available on the internet.
Founders
Product
Problem
Drug discount programs like Medicaid Drug Rebate Program (MDRP) and 340B are complex, and noncompliance and duplicate discounts lead to revenue leakage for drug manufacturers and administrative burdens for covered entities and state payers. Existing methods for managing drug discounts are often opaque, inefficient, and rely on siloed data, hindering transparency and collaboration among stakeholders.
Solution
Kalderos offers a drug discount management platform that connects drug manufacturers, covered entities, and state payers to facilitate collaboration, improve data transparency, and ensure compliance. The platform leverages AI and machine learning to analyze claims data, identify noncompliant discount requests, and resolve disputes, reducing revenue leakage and administrative overhead. Kalderos provides a unified view of drug discount programs, enabling stakeholders to make informed decisions, streamline processes, and maintain program integrity.
Target Audience
The primary customers are drug manufacturers seeking to reduce revenue leakage, covered entities aiming to streamline compliance, and state payers looking to improve program integrity.
Features
- AI-powered engine to identify and resolve noncompliance issues and detect inconsistencies in discount requests
- MDRP Discount Monitoring: Provides a transparent view of Medicaid claim data, enabling manufacturers to dispute noncompliant claims directly with states
- Commercial Discount Monitoring: Validates commercial claims, enforces contractual terms, and supports effective contract negotiations with private payers
- 340B Pay: Facilitates real-time requests, verification, and payment of 340B rebates, preventing duplicate discounts
- Discount Hub: Streamlines good faith inquiry process for covered entities
- Data-driven platform integrating 20+ third-party data sources for a comprehensive view of drug discount claims
- Centralized platform for managing MDRP, commercial programs, and 340B discounts
- Dispute resolution workflows with states
- Exclusion center for monitoring PBM responses and claims statuses