The solution provides automatic eligibility checks for patients’ health plans enabling visibility into benefits, accumulators and up-to-date status of patient’s utilization. It offers out-of-pocket cost projections for complex episodes of care based on the patient's insurance benefits, treatment plan and provider rates. The out-of-pocket projection provides transparency for patients, enabling the organization to comply with value-based care initiatives. Its cost optimization capabilities deliver personalized analysis, identification and enrollment of patients to financial assistance programs, government plans and insurance optimization opportunities. It offers full coverage of every financial navigation opportunity available, including: pharma copay, free/replacement drugs, local and nationwide foundations, and state and federal government plans With its insurance optimization capabilities, you get dynamic analysis of patient’s benefits to identify opportunities of benefit maximization, enrollment to additional coverage, or replacement to a more cost-effective health plan. The analysis takes enrollment opportunities into account and projects the potential value for patients and providers
