ACTICS eAccess

ACTICS eAccess is a platform designed to enhance the process of electronic benefits verification (eBV) and prior authorization (ePA). Traditional methods often result in only 60% accuracy and over 70% rejection of prior authorization submissions, leading to delays in patient treatment. This platform aims to streamline insurance eligibility verification, reducing confusion and frustration for healthcare provider (HCP) staff and ensuring timely treatment initiation.

By leveraging electronic connectivity with over 1,500 payers, ACTICS eAccess confirms pharmacy and major medical benefits coverage with high accuracy in minutes using just five data points. This approach significantly reduces the time required for annual and monthly reverification by 50%, without increasing staffing needs.

Key Features

• Integration of Pharmacy Benefit (PBM) and Major Medical: Verifies patient benefits with minimal input, ensuring comprehensive coverage understanding.
• NDC and J Code Specific: Provides detailed patient profiles and predicts out-of-pocket costs, promoting price transparency and affordability.
• Real-time Access: Offers HCPs and office staff immediate access to coverage information through an online portal or CRM-integrated platforms.
• Automated Business Logic: Assesses copay support eligibility and determines insurance coverage and product access.
• Built to Product Archetypes: Supports retail, specialty pharmacy, and buy-and-bill models, reducing manual effort and therapy initiation delays.

EVERSANA’s proprietary software ensures industry-leading accuracy and success rates in benefits verification, supported by real-time digital connections to payers. The platform enhances efficiency by reducing time spent on patient data tracking and verification submissions, and it offers reliable Patient Assistance Program (PAP) eligibility verification to optimize financial support allocation.

The system is flexible and customizable, allowing seamless integration into client CRMs and supporting the growth of client programs through additional products or services. It provides actionable insights to field reimbursement managers, reducing patient wait times and therapy initiation delays, while promoting patient-first affordability through enhanced price transparency.