PM360 2020 Innovative Product Benefit Verifications Leveraging Digital Assistant Payer Calls from Lash Group

Benefit Verifications Leveraging Digital Assistant Payer Calls

Lash Group

Bob Landers, Vice President of Sales

In late 2019, Lash Group collaborated with Infinitus Systems to pilot their Digital Assistant technology as part of Lash Group’s electronic benefit verification (BV) service. Digital Assistant leverages an automated call platform to verbally interact with systems and users just as a human counselor would. Extending beyond the commonly used individual question and answer format, this technology—the first of its kind in the patient support industry—facilitates lengthy, interactive conversations with payers to obtain patient insurance information and return BV results.

Lash Group’s algorithm determines when a BV case may be best matched for a digitally enabled payer call and assigns it to the Digital Assistant. The Digital Assistant calls out to the payer and navigates their call system so it may collect required information. Once reaching a representative, it asks verification questions based on data provided and then dynamically responds to payer representative answers. It leverages AI paired with natural language recognition and speech synthesis technology to ensure a positive and humanlike experience for the payer representative on the other end of the line. After the Digital Assistant collects the responses, Lash Group’s AI platform uses that information to provide the explanation of benefits and close the BV case.

Lash Group’s internal data shows that more than 80% of digitally assisted BV calls are automated and completed within 24 hours. The Digital Assistant can conduct thousands of calls at a time, while also balancing call loads by the payer in order not to overwhelm their contact center. Speed to therapy is critical, and collecting reliable, accurate BV results as quickly as possible is key to shortening the time from prescription to treatment initiation.


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