- Before
- Runs 20–25 investigations a day against a 48-hour promise, with the eBV saying one thing, the payer another, and both in different windows.
- Now
- Opens a summary already built, with every disagreement quoted side by side and its reason; settles, confirms and signs.
One benefits investigation, from enrollment to released summary
Jordan Ellis is prescribed Veltrimab 150 mg/mL pen by Dr. Rafael Moreno at Lakeside Dermatology Associates. The plan is Brightwater Health PPO, with Aldenway Rx as the PBM. The office enrolls Jordan through its portal on Oct 6 at 16:20 — case BV-2417. Here is what happens next, screen by screen, in the working solution.
- 01Oct 7 · morning
Five sources in, nothing built yet
Dana Okafor · Benefits specialistBy the next morning the case holds the hub record from enrollment, the pharmacy eBV from the clearinghouse, a 14-minute payer call transcript from Oct 7 09:12, the formulary's Jul 1 update and a capture of the portal's PA criteria page. The eBV reads cleanly: tier 4, $50 copay per fill, prior authorization not required, step therapy not indicated. Its benefit data is as of Jun 15, 2026. The case is 17 hours into a 48-hour promise.
“Ready to build. Every value will cite the eBV line, the call moment, the portal page or the plan page it came from.”
- 02One click
“Build the summary” — and the PA conflict surfaces
The agentsThe agents read every value from every source and write it into the summary with the lines it came from. Six values agree, four disagree, one needs confirming. On prior authorization the row turns amber and quotes both sides: the eBV's “Prior authorization: Not required” beside the payer rep at 05:05 — “Prior authorization is required: moderate-to-severe plaque psoriasis, at least 10 percent body surface or hands, feet, face or genitals, and 12 weeks of a conventional systemic.”
Why: “Brightwater added prior authorization when Veltrimab moved to tier 5 on Jul 1 … The eBV answers from Jun 15 data.”
- 03Settling
She settles all four with the newest dated source
Dana Okafor · Benefits specialistTier 5 since Jul 1, not tier 4. 30% after the deductible, up to $250 per fill, not the old $50 copay. Prior authorization required. Step therapy applies — one preferred biologic first. Each choice is recorded with what it overrode. She also confirms the signal the eBV never reported: a copay accumulator. Help from the Northwind copay program will not count toward Jordan's $2,500 deductible or $6,800 out-of-pocket maximum.
Source triangulator’s limit: “A person settles every disagreement.”
- 04Before the PA
PA criteria against the hub record: 3 of 4 met
Plan rules readerThe plan rules reader turns the portal criteria into a checklist and looks for each one in the case record. Plaque psoriasis — L40.0 on the enrollment form. Body surface 14%, recorded Sep 29. Methotrexate for 16 weeks, stopped for raised liver enzymes. The fourth, one preferred biologic first, is not met: Jordan has had no prior biologic, so the office should request a step therapy exception with the reason.
The plan rules reader never states that a PA will be approved.
- 05Drafted
An office summary where every value is numbered to its source
Summary writerThe office copy lists plan status, tier, cost share, deductible and out-of-pocket met, prior authorization, step therapy, the quantity limit of 2 pens per 28 days, Crestline Specialty Pharmacy only, and copay support — eleven values, each cited. It carries the payer call reference ALW-1007-55813 and the standard statement that a benefits investigation does not guarantee coverage or payment.
- 06The letter
A plain-language letter Jordan can read
Compliance checkerThe patient letter comes from the approved template PL-04 v3, in English or Spanish. The compliance checker passes it before anyone can release it: reading grade 5.8 against a limit of 6, template approved Sep 2 by Lena Ortiz, the no-promise sentence present, no diagnosis named, and the copay rule allowed for a commercial plan.
“It is not a promise that your plan will pay. Your plan makes the final decision.”
- 07Oct 7 · 09:53
She signs and releases
Dana Okafor · Benefits specialistRelease sends the summary to Lakeside Dermatology Associates by portal and fax, the letter to Jordan in English, and five tasks to Sam Patel. Dana signs with the meaning of her signature, her name and the date.
Meaning of signature: “I reviewed the benefits values and their sources and approve this release.”
- 08Released
Five next steps, already assigned
Sam Patel · Case managerHelp the office submit prior authorization through the Aldenway Rx portal, due Oct 9. A step therapy exception with Dr. Moreno, attaching the methotrexate history. A referral to Crestline Specialty Pharmacy. Enrollment in the Northwind copay program, planning the year around the accumulator. A call to Jordan to explain the benefits. A reverification reminder is set for Dec 1, 2026 — the plan renews on Jan 1.
- 09Next in the queue
Back to the queue: a medical-benefit case
Dana Okafor · Benefits specialistBV-2419 is Corventa 300 mg IV infusion at Northgate GI Infusion Center, under Cobalt Ridge HMO's medical benefit. The medical eBV says “Pre-determination not required”; policy MP-418 requires prior authorization for J3590, and the rep confirmed it. The agents explain the difference and flag a site-of-care rule after two infusions for her to confirm.
“The medical eBV answers whether a pre-determination is needed, not a prior authorization.”