Pharmacy Benefit Approvals

Pharmacy Benefit Approvals

Automate and streamline the pharmacy benefit approval process using Cflow’s automated solutions.

Why automate?

Pharmacy benefit approval is a crucial process that will ensure that patients have access to money for medicines and other pharmaceutical products. The process goes through different stages such as the verification of patient claim, their eligibility, and ensuring proper authorization. The process is time-sensitive and hence, must be effectively carried out. Delays in sanctioning these claims can cause slower treatments and medicine acquisition. Now imagine doing this for a multitude of insurers. Manual handling of this process can make the process inefficient, leading to delays, inaccuracies, and compliance issues. Automating the process can significantly improve the efficiency by streamlining all the stages. The automated workflow routes all requests to the right approver. This way, the process is no longer prone to errors, delays, and compliance issues.

How Cflow Can Help Automate the Process:

Streamlined Formulary Checks :

Cflow can be used to automate formulary checks within the approval workflow. This ensures that only medications covered under the patient’s plan are approved.

Automated Prior Authorization :

Cflow automates the prior authorization process by integrating with pharmacy systems and the workers. This ensures that all necessary approvals are obtained.

Compliance Management :

Cflow helps with stringent regulatory requirements. This ensures that insurers stay compliant by incorporating automated compliance checks into the workflow.

Real-Time Communication :

Cflow offers a real-time communication feature where companies can facilitate collaboration and communication. This ensures that issues or questions are addressed immediately.

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“I’m really impressed with the support provided by Cflow. There has never been a time when they have kept me waiting. A product that is simple to use and a team that is smart and extremely fast are factors that help me feel reassured and confident.”

Ronald Tibay

Ronald Tibay

Senior IT Manager @ NutriAsia, Inc

“The WFH environment during the COVID-19 pandemic made it clear how inefficient our processes were. Cflow allowed us to digitize paper forms with automated workflows. If you can envision a tool for an online workflow, it can be done in Cflow!”

Stephanie Duncan

Stephanie Duncan

Registrar @ Freed-Hardeman University

“We are extremely liking CFlow. So far any issues that we’ve had once we contacted support they were able to help us resolve the issue. This has helped us take a paper process and replace it, faster and more streamlined now for us.”

Bradley Wilkins

Bradley Wilkins

Director of Technology @Hazel Park School

Frequently Asked Questions

What is a pharmacy benefit approval?

A process ensuring that prescribed medications are covered under an insurance plan.

What are the main challenges in pharmacy benefit approvals?

Prior authorization delays, formulary restrictions, and high drug costs.

How can businesses ensure smooth pharmacy benefit approvals?

By using e-prescriptions, verifying coverage before dispensing, and negotiating bulk pricing.

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