In order to streamline procedures, reduce time, and boost revenue, medical technology is currently all about networking with various frameworks and advanced software solutions. There are several technological options available to confirm patient eligibility, and each of them will have some impact on the revenue stream.

e-Zest assisted a company that makes healthcare software by offering a complete PBM claims adjudication platform with real-time eligibility validation. The fundamental goal of this initiative was to increase the efficiency of the claim adjudication process by utilizing innovative technology that is accessible, reliable, speedier, and user-friendly for PBM enterprises.

As a result, the client desired to create a complete and reliable claim adjudication process that met the following requirements -

• Enhance the member experience by reducing the time it takes to process eligibility files
• Work with a multi-location team of SMEs and e-Zest's technology team to complete the project

The multilocational SMEs and team of e-Zest collaborated with the client and helped them in developing a tool used for Real-Time Eligibility File Validation.

As a client’s technology partner, e-Zest worked on:

• Process Time Optimization
• Performance Enhancement
• Business Process Optimization
• Notifications and Reports

Fill out the form for a detailed case study to know how e-Zest has improved the complicated and time-consuming eligibility validation process for pharmacy benefits was improved by e-Zest, resulting in a better member experience.