Real-Time Benefits Investigation (RTBI)
Verifies pharmacy and medical benefits in real time, including insurance coverage, out-of-pocket costs, coverage restrictions, coinsurance, formulary changes, copay amounts, remaining out-of-pocket limits, and remaining deductibles. An added MPE capability estimates medication costs for individual patients, including expected out-of-pocket costs.
HIGHLIGHTS
- ELECTRONIC BENEFIT VERIFICATION
- DIRECT CONNECTION TO MOST INSURANCE PLANS
- ACCESS TO PLAN AND COST INFORMATION
- DECISION SUPPORT
- SECURED AND CERTIFIED
Real-Time Services
300M+
Individuals
Unique Identities
90K+
Pharmacies
Pharmacies across the US
9.4M+
Providers
NPI Records
1,000+
Payers
Government, Commercial Payers
18B+
Claims Database
claims records
GuardianRx™/ShieldRx™
8.5M+
Patients
Patients supported
8M+
Claims Adjudicated
claims Adjudicated
90K+
Transactions
Transactions Daily
77M+
Rejections
Cost avoidance
4.5B+
Savings
Revenue protected
Real-Time Monitoring and Alerting
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