Eligibility & Benefits Verification
Confirm coverage, copays, and deductibles before the patient walks in — preventing the 30% of denials that stem from incorrect or outdated insurance data.
Stop Denials Before They Start
Eligibility errors are the #1 preventable cause of claim denials. Our verification process eliminates them at the source.
Prevent 30% of Denials
Invalid or outdated insurance data causes nearly a third of all claim denials. We catch these before charge entry — not after rejection.
Direct Payer Communication
We contact payers directly to verify and document all benefits in real time — no assumptions, no guesswork.
Better Patient Experience
Patients receive clear, upfront cost estimates. No billing surprises means higher satisfaction and faster self-pay collections.
Same-Day Verification
Eligibility confirmed before the patient arrives — every time. No retroactive rejections, no last-minute scrambles.
Detailed Benefit Breakdown
Full written benefit summaries provided to your clinical and billing staff for every verified patient appointment.
Automated Eligibility Checks
Batch verification for your entire upcoming schedule — proactively flagging any coverage issues days in advance.
How Eligibility Verification Works
Schedule Receipt
We receive your upcoming patient schedule — typically 24–72 hours before appointments begin.
Real-Time Payer Query
We run real-time eligibility queries through clearinghouses and direct payer portals for each patient on the schedule.
Manual Follow-Up
Any unconfirmed or flagged cases are followed up manually with the payer by our verification specialists.
Benefit Summary Delivery
Detailed benefit summaries are entered into your EMR or shared with your front desk before each appointment.
Flag Issues in Advance
Any coverage gaps, authorization requirements, or benefit limits are flagged to your team immediately — giving you time to act.
Common Questions
Other Ways We Protect Your Revenue
Charge Entry & Clinical Scrubbing
CPT, ICD-10, and modifiers verified within 24 hours using 4M+ automated checkpoints. Reduces first-pass rejections by up to 60%.
Same-Day Claim Submission
Every claim scrubbed and submitted same day as charge entry. 95%+ acceptance rate with major payers. Zero claim backlog.
Denial Management & Appeals
Denials analyzed, corrected, and resubmitted within 48 hours. Root-cause tracking ensures the same denial never hits twice.
Payment Posting & Reconciliation
Line-by-line ERA and EOB reconciliation daily. Every dollar matched, every discrepancy flagged. Audit-ready books, always.
Patient Helpdesk Support
HIPAA-compliant agents handle patient calls, payment plans, and balance inquiries — reducing your front-desk workload significantly.
Let’s Find the Revenue
Your Practice Is Missing
Start with a free, no-obligation 2-week audit. Most practices uncover $100K–$500K in recoverable revenue.