In contrast to other technology solutions, Benefit Source connects directly to payers and consumes third party data sets from private and government payers to report back up-to-date and more accurate results. And the number of payers and data sources that Benefit Source connects to is continually expanding. In addition, because of this direct connectivity, data provided back to manufacturers reflects real-time benefits coverage that is accurate on all fronts – prescription data, insurance plan specifics and treatment details. This contrasts with other eBV systems that use analytical tools and historic data to predict what a payer will cover, but don’t consider patient- and payer- specific factors, like a preferred specialty pharmacy or days’ supply quantity limits.
In its time on market thus far, Benefit Source demonstrated a significant decrease in administrative wait time – delivering results in minutes compared to more extensive time on the phone with payers. Benefit Source was recognized by PM360 as a top innovation of 2019 for the advances it delivers to electronic benefits processing.
One of the most significant advantages of Benefit Source is its scalability—the ability to perform benefits verification in large batches in very short periods of time, particularly during annual benefits verification season. For biopharma manufacturers that perform annual reverifications on patients, this process can decrease the reverification timeline by weeks or even months, while significantly reducing labor costs. In many cases, Cardinal Health Sonexus™ Access & Patient Support has managed the electronic benefits process ahead of involving the current hub services partner to reduce their workload and drive savings for the brand. See case study below.
The reverification process relies on information provided by physician offices as well. This work is also moving into the digital realm. Instead of picking up the phone or faxing, HCP offices are accessing the hub via online portals.
After a secure user verification process, the reverification process can be started and supported with:
- Electronic submission of benefit reverification requests
- Accessing copay savings and activating free drug vouchers to help offset new out-of-pocket costs
- Performing patient assistance program pre-screening for those whose treatments may no longer be covered or anticipate a gap in care
- Downloading and completing appeal forms
- Checking in on access status instantly and understanding next steps
New efficiencies are achieved as the number of incomplete forms submitted by provider offices are reduced and self-serve dashboards create quick visibility to tasks awaiting action. Portals that offer integrated copay assistance can even prompt physician offices with copay assistance resources to help address any changes in out-of-pocket expenses that come with a change in insurance coverage.
Determining your reverification season strategy requires preparation. For biopharma clients working with Cardinal Health Sonexus™ Access & Patient Support, the value realized through Benefit Source as a primary or secondary part of their reverification strategy is the ability to quickly scale up operations, improve turnaround time and accuracy, reduce the expense involved in this annual process and – most importantly – provide a clear path to care for patients.