Verify Before the Visit.
Collect Every Time.
We confirm every patient's insurance coverage, benefits, copays, and authorizations before they walk through your door — eliminating surprise denials and protecting your revenue from the very first step.
Deductible not yet met — patient responsible for $820 before plan pays. Collect at time of service.
No More Surprise Denials. Ever.
Insurance eligibility errors are one of the top causes of claim denials — yet they are entirely preventable. Our team verifies every patient's coverage in real time before their appointment, giving your front desk and billing team everything they need to collect correctly from day one.
We go beyond simple active/inactive checks. We confirm the full benefit picture — deductibles, copays, coinsurance, out-of-pocket maximums, prior authorization requirements, and referral needs — so there are no surprises for you or your patients.
- Real-time verification for every scheduled patient
- Active coverage & plan type confirmation
- Deductible, copay & coinsurance details
- Prior authorization & referral requirement checks
- In-network vs. out-of-network status confirmation
- Secondary & tertiary insurance coordination
- Patient cost estimation & front-desk communication
Complete Coverage Confirmed. Every Visit.
We check every detail of a patient's coverage — not just whether their insurance is active.
Active Coverage Status
We confirm the patient's insurance plan is active, effective, and in-force on the date of service — catching terminated or lapsed coverage before the patient arrives, not after the claim is denied.
Copay & Coinsurance
We retrieve the exact copay amount for each visit type — office, specialist, urgent care, ER — and confirm the patient's coinsurance percentage so your team can collect the correct amount at check-in every time.
Deductible & Out-of-Pocket
We confirm how much of the patient's annual deductible has been met and how much remains — along with out-of-pocket maximum tracking — giving your team an accurate patient responsibility estimate before every visit.
Prior Authorization
We identify which procedures and services require prior authorization before they are performed — and flag referral requirements — so your team can obtain approvals in advance and avoid costly after-the-fact denials.
Network Status
We confirm whether your provider is in-network for the patient's specific plan — including plan type (HMO, PPO, EPO, POS) — so billing is applied correctly and patients are informed of any out-of-network cost implications.
Coordination of Benefits
When patients carry multiple insurance plans, we identify the primary and secondary payers, confirm coordination of benefits order, and ensure claims are routed and sequenced correctly to maximize reimbursement.
Our Verification Process — Step by Step
A systematic, pre-visit workflow that protects every appointment from eligibility-related revenue loss.
Schedule Import & Patient Identification
We pull your appointment schedule daily — directly from your EHR or practice management system — and identify every patient scheduled for the next 48–72 hours. No manual uploads or extra steps for your team.
Automated daily pullReal-Time Payer Verification
We submit real-time eligibility transactions (270/271) to each patient's insurance carrier — receiving the full benefits response including plan details, deductibles, copays, coinsurance, and authorization requirements.
270/271 EDI transactionsBenefits Review & Issue Flagging
Our team reviews every eligibility response and flags issues that need attention — inactive coverage, high remaining deductibles, missing authorizations, out-of-network status, or COB discrepancies — before the patient arrives.
Human review on every resultFront Desk & Billing Notification
Verified eligibility results are posted back to your EHR and communicated to your front desk team — including exact copay amounts, patient responsibility estimates, and any flags that require action before or during the visit.
Direct EHR integrationAuthorization & Referral Coordination
When a prior authorization or referral is required, we initiate the request process immediately — contacting the payer, submitting clinical documentation, and tracking approval so no service is rendered without coverage confirmed.
No auth = no surprise denialPost-Visit Reconciliation
After each appointment, we reconcile verified benefits against the actual claim to catch any discrepancies early — ensuring payment posting aligns with expected reimbursement and patient collections are complete.
Full-cycle accuracyThe Real Cost of Skipping Verification
Many practices only check whether a patient "has insurance" — and pay the price later. Incomplete verification leads to claim denials, underpayments, write-offs, and frustrated patients who didn't know their out-of-pocket responsibility.
Our comprehensive verification eliminates these problems entirely — protecting your revenue before it's ever at risk, improving patient satisfaction, and reducing the downstream billing work that comes from eligibility errors.
- Eliminate 30% of claim denials caused by eligibility errors
- Improve patient satisfaction with upfront cost transparency
- Reduce front desk time spent on insurance questions
- Collect correct patient responsibility at time of service
- Prevent costly retroactive authorization denials
Eligibility Errors Cost You Thousands Monthly
Denied claims from inactive coverage, wrong payer, or missing authorizations are often unrecoverable. Preventing them is far more effective than appealing them after the fact.
Patients Hate Surprise Bills
When patients receive unexpected bills because their deductible wasn't communicated upfront, it damages trust and slows collections. Our verification gives patients accurate estimates before every visit.
Auth Denials Are Entirely Preventable
Services performed without prior authorization — especially imaging, specialist referrals, and procedures — result in full claim denials. We catch every auth requirement before the patient is seen.
Your Staff Shouldn't Be Doing This
Manual eligibility checks are time-consuming, error-prone, and pull your front desk away from patient care. We automate and handle the entire process so your team can focus on what matters.
Payers We Verify With
Stop Denials Before They Start.
Let us show you how real-time eligibility verification can eliminate 30% of your claim denials and improve patient collections from day one.
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