Most administrative pharmacy transactions are automated, study finds

Most pharmacy claim submissions, electronic prior authorizations and eligibility and benefit verifications are conducted via automation, according to the Council for Affordable Quality Healthcare Pharmacy Services Index.

The index, released Dec. 15, analyzed automation levels among pharmacy benefit managers for three common administrative transactions in 2019. The data, which was contributed by PBMs, represent 65 percent of all covered individuals in the U.S.

The automation levels for three types of pharmacy administrative transactions:

  1. Claim submission: 99 percent

  2. Eligibility and benefit verification: 94 percent

  3. Electronic prior authorization: 75 percent

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