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While the disparities in eligibility and benefit verification and electronic prior authorization might be due to several factors, this data suggests there are opportunities for greater automation across the industry. (Image: Shutterstock)

Pharmacy benefit managers (PBMs) are ahead of health plans in automating key administrative workflows, according to the first CAQH Pharmacy Services Index — a report that examines the levels of automation for three common administrative transactions.

“The initial data indicates that PBM administrative transactions are generally more automated than similar medical transactions, but this is just the first step,” April Todd, CAQH’s senior vice president for CORE and Explorations, said in a statement. “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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