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How automation helps more patients stay on track with their therapies

By AmerisourceBergen

The right eBV solution will effectively manage annual reverification (AR) volume and minimize negative patient impact

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Once only a human-intensive task, benefit verification has become faster than ever thanks to advances in automation. With artificial intelligence (AI), machine learning, digital assistants, and escalation algorithms, electronic benefit verification (eBV) platforms are better positioned to complete requests on-demand, accelerating speed-to-therapy for patients.

Lash Group's experience with AR and ability to scale is unmatched. Whether during AR or not, that speed gives patients the best benefit of all: Faster access to life-saving and life-enhancing therapies.

A quick-acting and adaptable combination of AI-based SmartPoint eBV technology and team member expertise can flex to support patient populations, and offers the capability to plan for and execute large volumes. True automation technologies deliver the highest possible percentage of completed eBVs during the patient's doctor visit, any time of year, not just during AR season. Over the course of decades, well-honed processes and technology have enabled patient-first results.

But not all eBV solutions perform equally—a challenge that can become abundantly clear during the high volumes of annual reverification (AR). This busy season involves caseloads as large as the current patient population, which can reach hundreds of thousands or more. If the chosen eBV platform fails to automate most of those cases, it can create therapy delays for patients and increased administrative time for providers, reducing the time they have available for patient care.

Short timelines mean extra pressure on eBV vendors

The caseloads experienced during AR can be extreme and with a short turnaround time. While many eBV vendors purport to be tech-first and prepared for these fast turnarounds, claims often overstate the maturity of the solutions' end-to-end automation capability or otherwise mask the level of human support required.

SmartPointSM relieves some of that pressure, using AI to reduce scheduled therapy delays by performing end-to-end automation. An electronic eligibility check feature also reduces a barrier to access, giving prescribers the details needed to make informed medication decisions for their patients and their patients' particular coverage.

People plus processes

Technology touches every aspect of AR programs, enhancing their efficiency and accuracy. While successful AR programs should be tech-first, it's not just about the technology or even the skilled associates on the phone. It's also the leaders that are running the program overall who know how to address large volumes and changing dynamics, and who ensure patient access is being prioritized by which cases are handled first.

By assessing volumes and implementing corresponding strategies to prioritize late benefits verifications, we can mitigate the risk of delays. Skilled team members continually monitor progress and adjust processes, giving that human touch to efficient and accurate AR execution.

 

Ensuring success

  • Ensure your eBV vendor can meet the demands required of the program's benefit verification volumes, whether that's during AR or year-round

  • Scrutinize eBV technologies' automation rates and capabilities, including whether innovations such as artificial intelligence and machine learning are featured
  • Look for partners that offer advanced technologies, team expertise, and a willingness to flex and problem-solve for clients and patients

     

Explore how our patient access and annual reverification services can help accelerate your patients' path to therapy