Automated LTC Pharmacy Eligibility Verification Worklist
Every morning, WebRun opens FrameworkLTC and checks all new admissions and coverage-change events from the past 24 hours for payer eligibility status, flags residents where eligibility is unconfirmed, rejected, or shows a coverage gap, logs each case to a Google Sheet worklist grouped by facility and payer, and posts a Slack alert to your billing team so no medication ships to a resident with unverified coverage.
How do I automatically build a daily eligibility verification worklist for my LTC pharmacy?
WebRun checks FrameworkLTC every morning for new admissions and coverage-change events from the past 24 hours, verifies payer eligibility for each resident across Medicare, Medicaid, and commercial plans, logs all unconfirmed and rejected cases to a Google Sheet worklist, and posts a Slack alert to your billing team so no fill ships without confirmed coverage.
- No fill ships to a resident with unverified payer coverage
- Mid-cycle coverage changes are caught the next morning before the following fill is dispensed
- Billing team starts each day with a clear eligibility worklist instead of a manual audit
Built for long-term care pharmacies · LTC pharmacy billing coordinators · pharmacy revenue cycle teams · nursing facility admission pharmacy liaisons
What does WebRun do on every run?
The exact actions WebRun takes, in order - in plain language, so you can adjust anything.
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WebRun signs in and gets to work
Opens
www.frameworkltc.comin a real browser with your saved login - no setup, no API keys. -
1
FrameworkLTC - check eligibility status for new and changing residents
frameworkltc.com
WebRun opens FrameworkLTC to check eligibility status for new and changing residents. - Open FrameworkLTC and navigate to the eligibility and billing setup section
- Pull all new admissions and resident coverage-change events recorded in the past 24 hours
- Check the payer eligibility status for each: confirmed, pending, rejected, or coverage gap
- Flag residents where eligibility is not confirmed with the specific issue: plan not found, termination date passed, or pending response
Done when Every new or changed resident record from the past 24 hours has an eligibility status check.
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2
Google Sheets - log unconfirmed and rejected eligibility cases
google.com
WebRun opens Google Sheets to log unconfirmed and rejected eligibility cases. - Open the eligibility verification worklist Google Sheet
- Append each unconfirmed case with the resident identifier, facility, payer, issue type, and admission or change date
- Mark cases resolved when the billing team confirms eligibility in FrameworkLTC
Done when The Google Sheet worklist shows all open eligibility verification cases with full detail.
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3
Slack - alert billing team to open verification items
slack.com
WebRun opens Slack to alert billing team to open verification items. - Post a morning Slack alert to the billing team with the count of open eligibility verification items
- Group the count by facility and by issue type so the team knows where to focus first
- Include a link to the Google Sheet worklist for the team to action before the next fill run
Done when The billing team has the eligibility verification alert and worklist link in Slack.
How is each run configured?
Secure by default
Connect once, stays signed in
WebRun signs in once and keeps each session in a persistent environment, so every run picks up right where it left off.
Every action is checked against this policy before it runs.
Questions, answered
Will it contact the payer or the facility to resolve an eligibility issue automatically?
No. WebRun surfaces the unverified cases in an internal Slack alert and Google Sheet worklist. Any call or message to a payer or nursing facility to resolve an eligibility issue is carried out by your billing team after reviewing the case details.
Does it handle Medicare, Medicaid, and commercial plans?
Yes. It checks eligibility status for all payers configured in FrameworkLTC, including Medicare Part A and Part D, state Medicaid, and commercial insurance plans, so the worklist covers the full payer mix without separate manual checks.
What if a resident's coverage changes mid-cycle?
FrameworkLTC records coverage-change events in real time. This run checks the past 24 hours each morning, so mid-cycle coverage changes are caught and added to the worklist the following morning before the next fill is dispensed.
Related templates
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