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CAQH Study: Initial Results Show Pharmacy Administrative Transactions Are Highly Automated


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WASHINGTON, Dec. 15, 2020 /PRNewswire/  CAQH today released the first CAQH Pharmacy Services Index, a report that examines levels of automation among pharmacy benefit managers (PBMs) for three common administrative transactions. This initial research suggests that PBMs generally conduct a higher percentage of these transactions electronically than medical plans, likely due to different workflows, volumes and levels of transaction complexity. 
The initial data indicates that PBM administrative transactions are generally more automated than similar medical transactions, but this is just the first step, said April Todd, CAQH Senior Vice President for CORE and Explorations. Based on these preliminary findings, we hope to expand our research to include providers and additional transactions to understand the differences in how administrative functions are conducted and to pinpoint opportunities for greater automation. ....

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