A large ambulatory infusion center network — managing patients across specialty conditions including rheumatology, pulmonology, and gastroenterology — faced mounting operational challenges. Disorganized upfront administrative work was creating downstream claims errors, and slow benefit investigation turnarounds were delaying patient access to critical infusion therapies. The center partnered with CareTria Provider Connect (formerly eBlu Solutions) to overhaul its benefit investigations process, with transformative results.
Like many high-volume ambulatory infusion centers, this organization faced two compounding operational problems that were creating friction across its entire revenue cycle.
These problems were not isolated incidents. They reflected systemic gaps in the center’s administrative workflow that required a technology-forward solution to solve at scale.
The infusion center engaged CareTria Provider Connect, a purpose-built platform specializing in automated benefit investigation and specialty drug administration support. CareTria Provider Connect was integrated into the center’s workflow to centralize, automate, and accelerate the benefit investigation process across all infusion sites.
Automated Benefit Investigations
CareTria Provider Connect’s automation engine allows the infusion center to submit benefit investigations and receive results with dramatically reduced manual effort. The platform handles the complexity of payer-specific rules and coverage lookups for infused biologics, enabling staff to confirm chair scheduling and initiate prior authorizations faster — without spending hours on hold with payers.
Structured Upfront Administrative Workflow
By standardizing how insurance and patient data is captured and validated at the front end of the infusion intake process, CareTria Provider Connect reduced the downstream errors that had been triggering claim rejections. A cleaner intake process produces cleaner claims — fewer denials, less rework, and faster reimbursement for high-cost infusion drugs.
Intelligent Routing and Provider Review Flagging
Not every case can be resolved automatically. CareTria Provider Connect’s system intelligently identifies cases requiring provider-level review (NPR), ensuring complex infusion authorizations receive appropriate human attention without slowing down the majority of straightforward investigations. This year, 2,565 cases were appropriately escalated and resolved without disrupting overall throughput.
Since implementing CareTria Provider Connect, the ambulatory infusion center has seen measurable, sustained improvements across its benefit investigation operations:
Unbelieveable Results:
High-volume throughput managed seamlessly across all infusion sites without manual bottlenecks or staff burnout.
Near-complete same-day turnaround on benefit investigations, enabling faster prior authorization initiation and infusion appointment confirmation.
The vast majority of investigations complete in under a minute, freeing staff time for higher-value patient-facing tasks.
By partnering with CareTria Provider Connect, this ambulatory infusion center resolved two of its most persistent operational pain points: slow benefit investigation turnarounds and the claims errors that stemmed from inconsistent upfront administrative work. The results speak for themselves — nearly 100% of benefit investigations now return within 24 hours, over 80% complete in under 60 seconds, and the center has processed more than 55,000 investigations year to date with a fraction of the manual effort previously required. For ambulatory infusion centers managing high-cost biologics across multiple sites, the operational and financial stakes of getting benefit investigations right are significant. An unbilled infusion is revenue that can’t be recovered. CareTria Provider Connect delivers the speed, accuracy, and scale needed to protect that revenue — so infusion teams can spend less time chasing coverage and more time caring for patients. For ambulatory infusion centers managing high-cost biologics across multiple sites, the operational and financial stakes of getting benefit investigations right are significant. An unbilled infusion is revenue that can’t be recovered. CareTria Provider Connect delivers the speed, accuracy, and scale needed to protect that revenue — so infusion teams can spend less time chasing coverage and more time caring for patients. Let’s talk.
