How Pharmacies can Benefit from our products

Independent and chain pharmacies alike are fighting a two-front battle: a mounting administrative burden and rising patient expectations for friction-free access to medication. Every prior authorization form, benefit eligibility check, and copay program adds minutes—or hours—to the fill queue, stretching staff thin and risking customer loyalty.

Our AI-driven product suite removes those bottlenecks by automating the slowest, most error-prone steps in pharmacy operations. The result? A faster path from prescription to pickup, healthier margins, and happier patients.

A Four-Part Automation Strategy

We combined four complementary products—AI Voice Call Prior Authorization, Insurance Eligibility Verification, Medicare/Medicaid Fraud Detection, and Maximizer & Accumulator Monitoring—into one seamless workflow built for pharmacies.

Below you’ll see how each product slots into the dispensing life-cycle and what measurable impact early adopters are already seeing.

  • 1
    Slash Manual Phone Time

    AI-initiated voice calls submit prior-auth requests in <10 minutes, freeing technicians from 14.6 hours of weekly hold music.

  • 2
    Stop Claim Denials Early

    Real-time eligibility checks reduce coverage-related denials by up to 25 % and surface lower-cost formulary alternatives instantly.

  • 3
    Protect Revenue & Patients

    Fraud analytics and accumulator monitoring safeguard reimbursement and ensure copay assistance is applied exactly as intended.

Case Study: Riverfront Community Pharmacy

Riverfront Community Pharmacy in Dayton, OH fills 3,600 prescriptions weekly—35 % of which require a prior authorization or specialty benefit verification. Before implementation, two technicians spent most of their shifts on payer portals, fax machines, and 1-800 lines.

In January 2025, Riverfront deployed our full automation stack. Within the first 60 days the pharmacy:

Key Outcomes After 60 Days

• Reduced average time-to-approval from 46 hours to 6.5 hours
• Recovered $17 K in revenue by preventing payer re-adjudications
• Redirected 1.1 FTE from paperwork to vaccination services, boosting clinical revenue

How did they get there? The secret is intelligent orchestration of data from four distinct modules, each feeding the next.

  • AI Voice Call Prior Authorization → Initiates and tracks PA cases with payers, attaching EHR data and prescriber signatures automatically.
  • Insurance Eligibility Verification → Confirms medical & pharmacy benefits in milliseconds, flagging plan carve-outs or step-therapy rules.
  • Medicare/Medicaid Fraud Detection → Cross-checks claims against CMS data and risk zones, alerting staff to suspicious billing patterns pre-submission.
  • Together, they create a closed-loop, fully auditable workflow that scales from one pharmacy to an entire regional network.
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