Benefit verification is one of the first steps after a patient schedules an appointment or is prescribed medication, but that doesn’t mean it’s a quick, easy, or inexpensive task. In fact, studies show that up to a quarter of total national healthcare costs can be chalked up to administrative expenses like benefit verification.

Despite attempts to solve this challenge – for example, with electronic options like eBV – costs and complications continue to multiply. Last year, according to the 2022 CAQH Index, provider time to complete transactions like benefit verification increased, on average, 15%. And, to make matters more difficult, “new staff often required more time to complete administrative tasks.” 

That’s why automating benefit verification with AI, as Infinitus does, is the right solution for healthcare providers and patient support offerings looking to streamline their administrative operations. 

Below, you’ll find the top 10 reasons to automate benefit verification with AI.

1. Go further than electronic options

Electronic benefit verification (eBV) solutions were created to help streamline complex data-gathering processes, and in many cases they do accomplish that goal. But unfortunately, often eBVs can’t be 100% completed without someone making a phone call to capture missing data anyway. When AI takes over the data-gathering process, you don’t need to worry about whether or when to make a call to a payor at all – the AI handles it for you. 

2. Save time and boost productivity

Healthcare professionals tend to gravitate to the field because they care about others and genuinely want to help; not because they aspire to spend hours on hold waiting to verify a patient’s insurance coverage. Offloading benefit verification to AI empowers back-office staff to spend their time on more complex or pressing needs, instead of researching phone numbers or waiting to speak to a payor agent.

3. Reduce training needs

By working with a healthcare AI company that has expertise in a variety of therapies and understands how to verify information with different major payors and pharmacy benefit managers, you won’t need to spend time or resources training seasonal staff to handle fluctuations in call volumes, like those that occur every January

4.  Address staffing challenges

The US healthcare industry continues to face staffing shortages, and hiring and retaining staff has never been harder as workers retire, change industries, or simply quit. By offloading the necessary work of benefit verifications to AI, however, staffing challenges can be minimized. AI doesn’t replace staff, but it does successfully augment existing staff, helping improve their day-to-day while helping organizations forgo the need to find and hire additional staff..

5. Keep up with changing volumes

Speaking of fluctuating volumes, automating benefit verification calls with AI allows healthcare providers to better navigate fluctuations in benefit verifications, during January’s annual reverification period or even unexpected changes in product usage volume. An AI solution can make five calls or 500 calls; human staffing needs don’t change. 

6. Stay up to date with changing rules

Insurance plans can change from year to year, and sometimes within the year, making it a challenge for even the most experienced healthcare administrator to stay on top of these developments. When you use AI to automate benefit verification, however, the AI will stay up to date, taking the pressure off staff to do so.

7. Expedite time to therapy

Benefit verification automation can leverage standardized call flows and, ideally, a wealth of data to collect required information in advance of treatment. This eliminates the need for multiple manual calls and ensures the correct information is acquired the first time, helping streamline patient time to therapy.

8. Improve accuracy

When humans are completing benefit verifications they’re prone to, well, human error. When using AI for automation, however, those errors can be reduced. The right automation solution will know how to acquire the appropriate information from payors, and can even push back – as the Infinitus digital assistant does – when incorrect information is provided. 

9. Provide a better patient experience

When staff is freed from the burden of waiting on hold with payors or pharmacy benefit managers, they’re freed up to spend more time in clinical interactions, focused on helping patients – very likely the reason they entered the field in the first place.

10. Incorporate AI into your plans in a safe and effective way

In 2023, healthcare leaders are being asked to create AI strategies – and it’s on these leaders to determine the best way to do so. When used appropriately, AI can take on the more tedious and repetitive elements of administrative work, and because its focus is on sharing data – not making decisions – benefit verification automation is one of the most effective and least risky ways to incorporate AI.

Why automate benefit verification with Infinitus?

Infinitus is the only solution that automates the entire phone call process to complete benefit verification calls to commercial and government payors and pharmacy benefit managers. As the expert in specialty medication benefit verifications, Infinitus has created eight standardized call types that have been able to address nearly every benefit verification need. The Infinitus digital assistant can collect 150 data points per call, including plan details, network status, and more. 

Our AI learns from every call made by our digital assistant, which itself relies on a vast pool of knowledge gained from having made over a million calls to date. This has given us unique insight into the patterns and best practices in exchanging data between healthcare companies – even when the data that must be communicated is nuanced.

To learn more about how Infinitus can help ease administrative burdens of healthcare, listen to a demo call or contact us today