At Infinitus, we spend a lot of time talking about the advantages of benefit verification automation. AI can transform healthcare’s back-office administrative processes, helping create time for the industry to improve access, adherence, and affordability – something we’re committed to as an organization.

But why is benefit verification, specifically, a strong fit for automation? 

Read on for a breakdown.

The repetitive nature of benefit verification makes it a strong candidate for AI 

AI can be extremely useful in cases where there’s a repetitive, routine, and time-consuming task at hand – and benefit verification is a perfect example of this. In fact, 595 million benefit verifications were completed manually (by phone, mail, email or fax) in 2022. Today, millions of minutes of human time are being spent collecting and transferring benefit verification data between payors and providers; automation can significantly reduce that number. 

Regardless of the patient or the doctor, the same information needs to be collected during the benefit verification process for a treatment, making it a strong candidate for automation, freeing up human workers’ time for more complex tasks.

The volume of data involved in benefit verification makes it ripe for AI assistance

In addition to the repetitive nature of benefit investigation, the sheer volume of data collection involved also makes it a prime target for AI. And often, all the necessary data must be collected from multiple locations (for example, some data may be available via electronic sources, other data must be collected via a phone call), another task where AI can be beneficial.

Moreover, AI can also help to standardize the data collection process across different entities in the healthcare industry. At Infinitus, for example, our digital assistant calls over 200 payors and has created standardized call types that can collect data across all of them for nearly every need. 

In benefit verification automation, key decisions are still left to humans

Although AI has the potential to greatly streamline healthcare processes, the risk of its use increases when it’s responsible for making any kind of decisions.

In the case of collecting benefit verification data, however, the AI isn’t making a decision – it’s simply collecting and transferring information. That means there’s minimal risk of bias, because the patient journey’s next step is left to human experts who have years of experience and specialized training. 

Automated benefit verification doesn’t replace humans; it augments their capabilities to perform their jobs better

AI should be seen as a tool to assist healthcare professionals, rather than a replacement for them. It can handle the repetitive, time-consuming task of benefit verification, freeing up time for healthcare staff to focus on the more complex aspects of their work. 

This means the healthcare workers involved in getting patients access to treatment are able to make the right decisions on what the next steps in a treatment journey should be. In this instance, the use of AI in healthcare is about enhancing efficiency and improving patient access and care, not about taking jobs away from healthcare professionals.

Why automate benefit verification with Infinitus?

Infinitus is the only solution that can automate 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 AI digital assistant can collect 150 data points per call, including plan details, network status, cost share, prior auth requirements and more. It 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.

Learn more about Infinitus’ benefit verification solution or contact us for a demo today.