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            Use Agentforce for Pharmacy Benefits Reverification

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            Use Agentforce for Pharmacy Benefits Reverification

            Accelerate pharmacy benefits reverification by automating the process of updating patient data. Update patient details with a single click. Ensure data accuracy and reduce manual effort by using Agentforce to draft and send emails that include a secure assessment link for patients to verify and provide their updated personal, drug, pharmacy, healthcare provider, and insurance details.

            Required Editions

            Available in: Lightning Experience
            Available in: Enterprise and Unlimited Editions with Health Cloud or Life Sciences Cloud licenses and Agentforce for Life Sciences Cloud or Agentforce for Health Cloud, Flex Credits Metering, Agentforce Employee Agent, Einstein GPT Platform, Einstein GPT Copilot, and Einstein GPT Prompt Builder add-on licenses
            Note
            Note The user interface of this product is available in English only and may not be fully supported in other languages.
            User Permissions Needed
            To use Agentforce:

            Access Patient Support Programs using Einstein
            To manage pharmacy benefits reverification requests:

            Manage Pharmacy Benefits Verification

            AND

            Access Patient Support Programs as a Case Agent

            Before you begin, Set Up Agentforce for Pharmacy Benefits Reverification. Make sure that the program lead has assigned the pending care benefit verification requests to you. See Use Pharmacy Benefits Reverification.

            1. Select a care benefit verify request record from the assigned list.
              Note
              Note To initiate the data updates for pharmacy benefits reverification, each care benefit verification request record must have a Pending status and the related care benefit verification request field must be populated.
            2. To draft the benefits reverification email, click the Draft Benefits Reverification Email agent quick action or pass any recommended utterance on the Agentforce window.

              You can also click the Draft Benefits Reverification Email recommended action on the Agentforce window.

            3. To copy the email content, click Copy Draft. To paste the email draft on the email window, select Send Email from the dropdown next to Copy Draft.
            4. Verify the recipients details on the email window, and click Send to send the email to the patient.
            5. Update the care benefit verify request status to Pending Confirmation.
            6. To summarize the response from the patient, click Summarize Patient Response, or pass any recommended utterance.
              After the patient responds to the assessment, the care benefit verify request status is automatically updated to Received Confirmation.
            7. Verify the patient's responses. You can update the details with just a click of Update Details button.
              After the patient details are updated, the care benefit verify request status is automatically updated to Ready for Verification.
              Note
              Note When you update patient details, ensure that you don't pass any update details related utterances.
              Important
              Important

              The Update Details button isn't shown when there's any change to the patient's insurance details. To update the patient details, a PSP rep can manually create insurance and care benefit verification request records.

            Initiate a manual or electronic verification request for benefits verification.

            See Also

             
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