How Automation Streamlines Pharmacy Benefits Reverification
With the reverification automation process, your reps can reverify patient benefits as needed. The automated reverification process significantly reduces manual intervention, ensuring accurate, timely updates and comprehensive communication of patient benefits details between patient services reps and healthcare professionals.
Required Editions
Available in: Lightning Experience
Available in: Enterprise and Unlimited Editions with the Health
Cloud or Life Sciences Cloud license. It's also available with these add-on
licenses: Agentforce for Life Sciences Cloud or Agentforce for Health Cloud, Flex
Credits Metering, Agentforce Employee Agent, Einstein GPT Platform, Einstein GPT
Copilot, Einstein GPT Trust, Genie Data Platform Starter, and Einstein GPT Prompt
Builder.
When a patient's record is updated and verified, the patient's benefits are automatically
reverified. You can check the status of the reverification process on the Care Benefit Verify
Request record page and the Care Program Enrolee record page.
If the verification mode is electronic, an email with a benefits summary is sent to the
patient's healthcare professional after the verification.
If essential details are missing or the verification mode is manual, the patient's insurance
provider receives an email requesting the missing details. After receiving the payor response,
the summary of benefits is shared with the patient’s healthcare professional.
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