How to Submit Beacon Claims

Getting registered for Beacon is the first step. The next is making sure the claims you send actually match what Beacon needs: the right covered entity, the right drug, the right units, and a file you can trace through to payment.

This guide walks through pharmacy and medical claims, using Beacon’s published instructions and downloadable templates. If you still need to set up your account, start with How to Register for Beacon 340B. For the bigger picture, see our 2027 rebate-pilot article.

Before you build the file

Confirm that you are working in the correct covered entity’s account. In My Workspace, review the outstanding setup tasks, including bank verification. A completed claim file does not resolve an unfinished payment setup. The W-9 belongs with account documentation; it is separate from the pharmacy and medical claim files. ^[3]

Check the exact 11-digit National Drug Code (NDC), manufacturer plan, effective date, and any entity-specific exception before treating a claim as part of the pilot. Pilot purchases use the existing 340B wholesaler account with wholesale acquisition cost (WAC) pricing loaded. The purchase must occur before the rebate request, including when the dispense precedes replenishment. ^[1]

We recommend assigning one submission owner. If a third-party administrator prepares or sends your files, agree on who handles uploads, reversals, rejected rows, and payment follow-up. That conversation is much easier before two teams submit the same claim.

Start with the right template

Download the current files from Beacon’s Resources page. It contains separate pharmacy and medical CSV templates, the NDC list, and onboarding documents. The field names below match the supplied templates; the quantity examples use Beacon RM – NDCs – 10.02.26.xlsx. Re-download the files when preparing a production submission so you are working from the latest version. ^[2]

Use the pharmacy template for pharmacy dispensing records and the medical template for drugs administered in an outpatient medical setting. Beacon provides separate submission instructions for each. ^{[6] [7]}

Pharmacy claims: 11 required fields

Keep each refill’s own fill number and service date. Beacon’s current pharmacy requirements describe these fields. ^[4]

Do not use a cash or missing-value code simply because the payer information is hard to retrieve.

Medical claims: a different file

The medical template has 12 columns. Beacon identifies 11 as required; health_plan_id_qualifier is supplied if available. Keep that column in the template without inventing a value. ^[5]

The current template does not contain HCPCS code or modifier columns. Its quantity follows the NDC’s units, rather than HCPCS billing units. Beacon directs wasted or undispensed units to a separate claim line; follow the applicable manufacturer’s instructions for that reporting. ^[5]

Check the units before you check the total

A package count and a claim quantity can describe very different amounts. Beacon’s NDC workbook separates package size from expected quantity increments. Two entries in the October 2 file show why that matters:

Both entries list the same expected quantity increments and units for pharmacy and medical claims. These examples explain the workbook; they do not establish eligibility for a particular claim. Source: Beacon’s October 2, 2026 NDC workbook. ^[2]

If a legitimate quantity does not fit an expected increment, resolve the discrepancy with Beacon. Do not round the record just to get it through validation. The same care applies to exporting a spreadsheet: preserve identifier fields as text and check the finished CSV for lost leading zeros, scientific notation, and changed dates.

Upload the file, then review what will actually submit

Beacon’s published pharmacy and medical walkthroughs follow the same general sequence. The menu labels below come from those instructions; older help pages may differ from the screens available as the 2027 launch approaches. ^{[6] [7]}

1. Open the appropriate submission screen. In the Claims module, choose Pharmacy Submissions or Medical Submissions.
2. Attach the file. Use Attach to select the corresponding claim file.
3. Choose the column mapping. Check that each source column points to its intended Beacon field. A saved mapping is useful only if the incoming layout still matches it. Beacon also documents creating and saving mappings through Column Mappings. ^[8]
4. Inspect the preview. Review the Submission tab. Correct formatting errors in the source file and re-upload it before proceeding.
5. Submit and confirm. Select Save and Submit, then Confirm Submission. Do not stop at the preview.
6. Download the receipt. Save the submission receipt, including the claim-level Beacon IDs, with your original export. Use the relevant Pharmacy Claims or Medical Claims view under Data Submissions to follow the records afterward.

One detail deserves its own check: a clean preview does not mean every row in the original file is being submitted. Beacon distinguishes the original file from the submission view. Records classified as ineligible can be excluded, while formatting errors on included records can block the file. Compare the two views. ^[9]

Our recommendation is to reconcile the original row count to the included and excluded rows, then keep an exception list with an owner and follow-up date. Removing a troublesome row from an upload does not resolve the underlying claim.

What if you find a mistake afterward?

Beacon distinguishes an initially rejected claim from an accepted claim that later needs a correction. A rejected record can be corrected and resubmitted. For an accepted record, Beacon’s FAQ directs users to reverse the original submission, then submit the corrected claim. Its reversal instructions call for matching claim details with a negative quantity. ^[10]

For example, if an accepted record incorrectly reported 30 units and should have reported 20, the documented approach is to reverse the original 30-unit record and then submit the corrected 20-unit record. Sending a second positive claim alone leaves the original error unresolved.

Keep the original Beacon ID, reversal, corrected record, and reason together. Beacon also advises submitting final claims rather than records still awaiting ordinary claim adjustments. ^[10] Agree with your submission partner on who will make each correction before either team sends it.

Follow the claim through to the rebate

Submission is one checkpoint. Reconciliation is how you determine what happened next. Track the claim, completion date, status, payment or denial, and any correction needed.

• Watch the submission window. HRSA requires plans to allow at least 45 calendar days from dispense, with allowances for extenuating circumstances and changes in 340B status. Set an earlier internal deadline so there is time to fix errors.
• Track when the submission is complete. The pilot requires payment or a documented denial within 10 calendar days of completed data submission. If the submission is returned as incomplete, that clock restarts when the necessary data is supplied.
• Reconcile units. The approved pilot pays rebates at the unit level. Do not use older descriptions of full-package accumulation as the 2027 payment rule. ^[11]

Keep supporting records internally. HRSA’s pilot data requirements do not call for purchasing or encounter data to be uploaded with these claims. A denial should have a documented basis consistent with the approved plan, not simply a generic compliance concern. ^[11]

For a problem you cannot resolve, work with Beacon and the manufacturer first. HRSA directs covered entities to make good-faith efforts to resolve issues before escalating unresolved pilot concerns to 340BPricing@hrsa.gov. ^[1]

Give the first file a closer look

Before the first live submission, have someone trace a few representative records from the source system to the export: one refill, one medical claim if applicable, one NDC with leading zeros, and one product measured in mL. Check who will catch an excluded row and who will match the receipt to the payment.

That review gives the team a repeatable process before volume increases. If you need help reviewing your claim workflow or preparing for the pilot, talk with 340B Auditor.