Today, more than 34.2 million Americans are enrolled in original Medicare plans. This can create a challenge for pharma hubs, pharmaceutical manufacturers, and healthcare providers, which must understand Medicare Part B coverage before treatment can proceed. 

That’s why Infinitus is excited to announce our newest offering: instantaneous Medicare Part B benefit verifications. With our new proprietary Medicare Part B solution, Infinitus customers can understand in seconds whether a patient is enrolled in Medicare Part B, whether a provider and/or site of care is in network, as well as coverage and coinsurance information for both locally and nationally covered products.

Until now, gathering this information has frequently required multiple sources and manual research – meaning lots of time has been spent on this tedious work. And time, as is well documented, is in short supply in healthcare. 

In addition to partnerships with third-party data sources and direct access to CMS data, the Infinitus Medicare Part B solution is made possible by our proprietary knowledge graph. The Infinitus knowledge graph contains up-to-date intelligence on commercial and government payor rules and guidelines that have been gathered from the millions of phone calls completed to date by the Infinitus AI agent, plus access to EDI, payor APIs, and policy documents. 

Infinitus customers can access the solution through the Infinitus Customer Portal, and upload tasks via CSV or API. Data is then returned instantly or, if there is an associated drug prescription requiring Medicare Part D coverage, the task can be passed on to the Infinitus AI agent. Our AI agent then automates a phone call to the identified pharmacy benefit manager (PBM), before data is returned to the customer in 24-48 hours. The solution can also identify and flag occasions when a patient is part of a Medicare Advantage plan.

This new solution is available as part of Infinitus’s full benefit verification offering, or as a standalone product. For more information, let us show you more or reach out to our team today.