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MODULE 04 · INSURANCE & ID CAPTURE

IN BUILD

It learns who you're dealing with.

A photo of the card and ID → the on-device model reads BIN/PCN/Group/Member ID and name/DOB/address → validates (6-digit BIN, payer lookup, name/DOB match) → stages an old-vs-new diff → staff confirm → writes to PrimeRx via UIA with read-back. Built for January plan-change season.

INPUTPhoto of card + IDOUTPUTUpdated PrimeRx patient recordWHENNew patient · plan change · COBGATEStaged diff → staff confirm

TODAY VS. WITH SSVP

What changes the day it installs.

Today — the manual way
  • Card and ID are hand-typed at intake, transposition errors and all.
  • Plan changes get caught at the register — as a rejected claim.
  • Nobody knows which PBM a patient is on until the claim bounces.
With SSVP
  • The model reads the card and ID once and validates every field.
  • An old-vs-new diff is staged for a one-click staff confirm.
  • BIN/PCN identifies the PBM and routes payer rules into audit defense.

Same counter, same PrimeRx, same pharmacist in charge — the keystrokes just stop being yours.

THE AGENTIC LOOP

Perceive. Reason. Act. Verify.

Four steps, every time. The agent handles the first three; a licensed pharmacist handles the last.
  1. 01

    Capture

    A photo of the card and ID is taken at intake — no keying.

  2. 02

    Read & validate

    The on-device model reads BIN/PCN/Group/Member ID and name/DOB/address, then validates the 6-digit BIN and matches name/DOB.

  3. 03

    Stage the diff

    Old-vs-new is staged so staff see exactly what changed before anything is written.

  4. 04

    Confirm & write

    Staff confirm; the record writes to PrimeRx via UIA with read-back verification.

    PHARMACIST SIGNED

The machine never signs. A licensed pharmacist does — every write is read back and compared before it counts.

WHAT IT RETURNS

The numbers it hands back.

6-digit BINvalidated + payer lookup
old-vs-newdiff staged for confirm
→ Module 03BIN/PCN routes payer rules

UNDER THE HOOD

Why this one holds up.

BIN → PBM routing

The BIN/PCN identifies the PBM, which routes the right payer rules into audit defense. Every capture makes the audit engine smarter.

Built for January

Plan-change season is a wall of new cards. This is the module that turns that wall into a queue of one-click confirms.

ONE ENGINE, FIVE MODULES

It doesn't work alone.

Typing feeds clean claims; clean claims plus live inventory feed audit defense; the same inventory feeds ordering; insurance capture tells every module which PBM it's dealing with. A competitor cannot reassemble this from parts.
MOD 01/05IN BUILD

Auto-Typing Engine

Reads every incoming Rx and types it into PrimeRx — pharmacist verifies, agent keys.

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MOD 02/05IN BUILD

Inventory Intelligence

Scan a bottle in, count goes up; every dispense read via UIA, count goes down.

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MOD 03/05PILOT

PBM Audit Defense

A daily exposure queue ranked by dollars-at-risk, and a reactive assembler that builds the defense package.

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MOD 05/05IN BUILD

End-of-Day Ordering Bot

At close, drafts a PO from the day's scripts and live on-hand — owner approves, EDI transmits.

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Want this module running on your PrimeRx?

Book a build call and we'll scope it against your store's real volume — and show you the log it keeps.

Book a build callor deep@deepshah.tech