Verifying pharmacy & medical benefits manually can lead to delays, errors, and administrative overhead. Our PBM Insurance Verification solution simplifies this process by automating insurance checks in real time.
Instantly confirm a patient's medical & pharmacy benefit eligibility, plan status, and medication coverage through secure integrations with major PBM networks & medical insurance payers. Reduce time spent on phone calls and faxes with automated, accurate insurance verification.
Designed for speed and accuracy, this tool enables healthcare providers and pharmacy staff to validate Medicual & PBM insurance within seconds, improving patient experience and accelerating the prescription process.
By minimizing coverage uncertainties and ensuring up-to-date benefit information, our platform supports better decision-making and maximizes claim acceptance rates—ultimately reducing costs and increasing efficiency.
Instantly verify a patient's medical & pharmacy benefits and coverage status, reducing delays and enabling faster care delivery.
Automate tedious verification processes and minimize manual errors, allowing staff to focus on patient care.
Ensure accurate and up-to-date coverage information before submitting claims, improving approval rates and reducing rejections.
Our system connects directly to Pharmacy Benefit Managers (PBMs) & Medical Insurance Payers, to verify a patient's insurance status, drug coverage, and plan details. With just a few data points, we eliminate the need for phone calls, faxing, or portal logins.
The platform is designed to fit seamlessly into your existing workflow, whether initiated from an EHR, pharmacy system, or custom form. Results are returned in seconds, allowing for faster decisions and better service.
Once a request is submitted, the system uses secure APIs to ping PBMs & Medical Payers, to fetch the most up-to-date eligibility and coverage data. This includes formulary information, copay estimates, prior authorization requirements, and benefit tier levels.
The entire process is automated and optimized for speed, accuracy, and compliance. Here’s a step-by-step breakdown of the workflow:
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