As a benefits dispenser—whether you're a Pharmacy Benefit Manager (PBM), employer group, or third-party administrator—accuracy, speed, and compliance are key to delivering value to patients and partners.
Managing eligibility, coordinating prior authorizations, detecting fraud, and ensuring compliant use of financial assistance programs are time-consuming and prone to costly errors. Our product suite solves these challenges with a plug-and-play AI layer that scales with your organization.
By automating and integrating key insurance workflows, our platform enables benefit dispensers to provide faster service, reduce manual overhead, and protect against risk. The result? Happier members, cleaner claims, and lower costs.
Here's how each product helps optimize the benefits distribution lifecycle:
AI voice agents submit, track, and follow up on prior auths—relieving pressure on call centers and enabling 24/7 response coverage.
Instant API lookups verify plan enrollment and pharmacy benefits—no more faxes, phone trees, or outdated portals.
Real-time CMS integration helps flag invalid coverage claims and mismatches, preventing fraud before funds are disbursed.
They implemented our AI solutions in Q1 2025 to improve operational efficiency and control spend across specialty programs.
• Reduced prior auth processing time by 78%
• Lowered claim rejection rate by 19%
• Prevented $180K/month in erroneous accumulator payments
By integrating directly into their internal claim engine and provider portals, ClarityRx gained end-to-end visibility into authorization, eligibility, and copay status—without requiring new infrastructure.
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