Lash Group Launches Artificial Intelligence-Powered Electronic Benefit Verification Solution

Staff Report From Greenville CEO

Thursday, May 17th, 2018

Lash Group, a patient support services company and an AmerisourceBergen company, announced the launch of its newest solution for electronic benefit verification. Powered by SmartPoint, a proprietary artificial intelligence technology, Lash Group’s eBV solution will accelerate speed to therapy and improve the care delivery experience for patients and providers.

“Benefit verification can be a significant barrier between patients and their ability to live healthier lives. This is especially true for the millions of patients whose benefits are still verified manually – through phone calls and paperwork exchanged among provider offices, payers and third-party hub support services providers,” said Tommy Bramley, PhD, President, Lash Group. “By applying advanced technologies to the healthcare space and pairing them with expert human intervention when required, we can drive faster speed to therapy and provide a more seamless experience for patients and providers.”

Benefit verification is an important process that helps patients access the therapies they need. The process checks a patient’s eligibility for the prescribed therapy, determines product benefits under that specific health plan, reviews how the benefits are coordinated, and provides quality review and guidance before the benefit summary is sent to the patient’s provider. Lash Group’s eBV solution automates thousands of these tasks to streamline the process for patients and providers.

Leveraging health coverage and payer data collected from millions of manual verifications as a reference base, Lash Group’s eBV solution uses artificial intelligence and machine learning to evaluate each incoming BV. If the SmartPointSM technology can predict the outcome for the incoming BV with high accuracy, then it’s processed real-time. Otherwise, it automatically routes the BV to a reimbursement counselor for expert intervention.

Designed for continuous improvement, Lash Group’s eBV solution learns and adds this new information from counselors, along with other changes in health plan coverage, copay and reimbursement models, to its algorithms, improving the quality and speed of future verifications.

Lash Group’s eBV solution will not disrupt existing workflows for providers and their staff. The benefit summaries generated by the eBV solution and by Lash Group’s reimbursement counselors are identical, so providers and their staff can easily interpret results with no additional burdens created for their workflow.