A prominent Pharmacy Benefit Management (PBM) company in the US faced challenges in managing the various aspects of PBM migration with their limited in-house resources. Prior to e-Zest's involvement, the client's migration process was entirely manual, leading to various challenges such as inaccurate claim execution for benefit testing, inconsistent refresh times, claims transfer, and verification, incomplete report generation, high operational costs, etc. Moreover, there was a lack of standardization in documentation and ineffective integration between systems.
To resolve these issues, the client chose e-Zest - An Accion Labs Company as a digital innovation partner. Our expertise in the PBM space and our proven track record in streamlining migration processes played a crucial role in overcoming these challenges. We established our own Testing Center of Excellence that consisted of innovative tools, accelerators, and our talented PBM SMEs. By leveraging our accelerators like eZBenefits, eZFormulary, eZCert, and eZSurv, our migration specialists automated the entire migration process, ensuring accuracy and efficiency. Moreover, e-Zest- An Accion Labs Company distinguished itself as a pioneer in the field by integrating Generative AI in PBM migration to ensure 100% accuracy, cost savings up to 30-50%, and a remarkable 50% improvement in operational efficiency.
Our approach to streamlining end-to-end migration processes drove substantial business outcomes, including:
- Accurate identification of 400+ member issues
- 800k+ claims execution to test at an NDC level
- Auto-validation of 99.8% paid production claims
- Validation of 2.1 mn production claims
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