Healthcare

PCH Tech Stack Provides Full Lifecycle Solution for Specialty Drug Administration

CHALLENGE:

Large pharmaceutical enablement company that works with numerous drug manufacturers to administer specialty drug programs began to feel the strain of their outdated technology capabilities. Specifically, unintegrated technology platforms and disparate legacy systems were creating challenges associated with a growing quantity of unstructured data and complex reimbursement claims documentation. The company was confronting unsustainable time and resource requirements related to ingesting, classifying, and adjudicating these materials.

SOLUTION:

What began as a request to solve a discrete need quickly grew to include complete, end-to-end support for the specialty drug lifecycle. Through Exela’s PCH platform and tech stack, all backend services were integrated, which enabled a shared data ecosystem and a smoother processing cycle across enrollment, claims processing and adjudication, billing and payments, and benefits verification.

  • Omni-channel data ingestion (email, fax, web, EDI, mail)

  • Connected ERP’s, 3rd parties, and legacy systems

  • Streamlined the entire product lifecycle

BENEFITS:

Exela’s solution provided a digital transformation across the entire specialty drug lifecycle, from enrollments to payments, which improved operations on several key metrics.

  • Reduced processing times

  • Improved accuracy of submitted claims

  • Enhanced user experience

  • Seamless connectivity between patients, providers, and payers

  • Increased quality and transparency into payments

  • Automated plan administration

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