Understand the Reverification Request Generation

The definition identifies existing care benefit verify request records within the date range and with the status specified by the Initiate Benefit Reverification flow user. The definition creates a copy of a care benefit verify request if the record isn’t referenced as a parent request in any other record.

The definition assigns a Copy status to the new record. The Copy status triggers the Copy Care Benefit Verify Request Fields flow.

The flow verifies that the care benefit verify requests to copy have a status of Copy, have a Related Care Benefit Verify Request value, and have no Authorized Prescription, Original Prescription, or Coverage Benefit values. For each record that meets these conditions, the flow creates copies of the original record’s medication requests, coverage benefit, coverage benefit items, and coverage benefit item limits. It then populates the Authorized Prescription, Original Prescription, and Coverage Benefit fields in the copied record.

• If the flow succeeds, it updates the status of the new care benefit verify request records to Pending.
• If the flow fails, for example because of a network connection issue, it updates the status of the new care benefit verify request records to Error. The error status indicates that the copy process is incomplete because the flow didn’t create any records or update the Authorized Prescription, Original Prescription, and Coverage Benefit fields in the copied record.

Program leads can share a list view of the pending care benefit verify request records with patient services reps, or they can assign pending requests directly to patient services reps. To reverify the benefits, patient services reps access the shared list or the pending records assigned to them. Patient services reps can update the pharmacy benefits coverage details for each of these records.

To trigger the copy flow manually for care benefit verify request records with a status of Error, change the status from Error to Copy.