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            Generate Benefits Reverification Requests

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            Generate Benefits Reverification Requests

            Program leads can use a screen flow to initiate a pharmacy benefits reverification request. The flow collects important reverification information and generates a list of new benefits verification records. Patient services reps can use the shared list or the records assigned to them to reverify the pharmacy benefits of care program enrollees.

            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.
            User Permissions Needed
            To use flows:

            Run Flows user permission

            AND

            Manage Flow user permission

            AND

            Customize Application user permission

            AND

            Modify All Data user permission
            To use data processing engines: Data Pipelines Base User permission set
            To manage pharmacy benefits reverification requests:

            Manage Pharmacy Benefits Verification permission set

            AND

            Access Patient Support Programs as a Program Lead permission set
            1. As a program lead, to run the Initiate Benefit Reverification screen flow, use the Reverify Pharmacy Benefits action on the care program record.
            2. Add the required data and click Next.
              Note
              Note If the selected end date is today, only the records that existed before today’s date are processed.
              A notification appears to indicate that the pharmacy benefits reverification request is complete.
            3. Manage new care benefit verify request records.
              The records that are ready to reverify have a Pending status.
              1. As a program lead, to send the records to patient services reps for processing, share a list view of the pending records or assign pending requests directly to patient services reps.
              2. As a patient services rep, access the shared list or the pending records assigned to you. Then open a care program enrollee record and click the Benefits Verification tab. To adjust coverage benefits, in the Benefit Summary section, click the Edit Benefits action and then edit the coverage benefits.
              Note
              Note If the screen flow doesn’t create the care benefit verify request records you expect based on the date range you specify, extend the end date of the date range by 1 or 2 days. For example, instead of specifying January 10 as the end date, specify January 11 or January 12.
              If issues such as network connectivity prevent the pharmacy benefits reverification request from being completed, the new records show an Error status. To fix these records, change the status from Error to Copy. This triggers the Copy Care Benefit Verify Request Fields flow, which creates required records and updates the Authorized Prescription, Original Prescription, and Coverage Benefit fields in the new records.
             
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