PM360 2019 Innovative Service Benefit Source from Cardinal Health Sonexus Access and Patient Support

Benefit Source

Cardinal Health Sonexus™ Access and Patient Support

Alex Buell, Director, Business Development and Sales
alexander.buell@cardinalhealth.com

In recent years, electronic benefits investigation (eBV) and electronic prior authorization (ePA) technology have been introduced to expedite the processing of insurance benefits and accelerate the delivery of care. Yet, while some eBV/ePA systems have effectively automated manual processes and reduced turnaround times, manufacturers using these platforms have continued to express frustrations. Cardinal Health Sonexus™ Access and Patient Support set out to build a better platform. The result is Benefit Source.

The Cardinal Health team leveraged their deep expertise in benefits and insurance requirements to write algorithms that would help to expedite approvals. For example, a certain medicine may only be covered for a certain dose or a specific days’ supply, such as 90 days. By building those conditions into Benefit Source, Sonexus™ ensures that initial requests meet the requirements and are less likely to be rejected unnecessarily.

Also, because Benefit Source connects directly to payers, the data provided back to manufacturers reflects real-time benefits coverage that it is accurate on all fronts—prescription data, insurance plan specifics, and treatment details. This is in contrast to other eBV systems that use analytical tools and historic data to predict what a payer will cover, but which don’t consider patient-specific factors, such as whether patients have already met their deductible.

Another advantage of Benefit Source is its scalability—the ability to perform benefits verification in large batches in very short periods of time. For manufacturers that perform annual reverifications on patients, this process can often decrease the reverification timeline by weeks, while significantly reducing labor costs. Applying this technology to patient assistance program eligibility checks, the efficiencies are so significant that manufacturers are able to move to quarterly or even monthly reverifications without increasing their costs.

Ads

You May Also Like

The Future of Computing—A Preview

Held annually in Taipei, Taiwan, COMPUTEX is considered to be the biggest computing event ...

Innovators 2017: Strategies

PM360’s Innovations Issue was established six years ago to serve as a comprehensive guide ...

ELITE 2020 Data Miner Stanley H Braxton of Ashfield Healthcare

Stanley H Braxton SVP Business Insights & Operations Ashfield Healthcare Architect of Agile Data ...