Eligibility Verification

Verify Before You Bill,
Collect Every Time

Pre-visit eligibility verification eliminates billing surprises, prevents eligibility-related denials, and ensures your patients understand their financial responsibility before the encounter.

30%
Denials Are Eligibility-Related
100%
Pre-Visit Verification
24 hr
Verified Before Appointment

Eligibility Errors Are Entirely Preventable

Up to 30% of claim denials are due to eligibility issues — inactive coverage, wrong payer, coverage limitations, or missing authorizations. Every one of these denials is preventable with proper pre-visit verification.

We verify patient insurance 24–48 hours before every scheduled appointment, confirming active coverage, patient responsibility amounts, deductible status, and any authorization requirements. Your front desk receives a complete verification summary before the patient arrives.

Practices that implement systematic pre-visit eligibility verification reduce eligibility-related denials by 90%+ — and collect significantly more patient responsibility at the point of service.
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What's Included

  • Verification 24–48 hours before scheduled appointments
  • Coverage active/inactive status confirmation
  • Co-pay, co-insurance, and deductible amounts
  • In-network vs. out-of-network status
  • Primary and secondary insurance coordination
  • Referral and prior authorization requirements
  • Verification summary delivered to front desk
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How Our Eligibility Verification Service Works

Every detail handled by certified professionals — so you can focus on patient care, not paperwork.

Pre-Visit Verification

Every scheduled patient verified 24–48 hours before appointment. You receive a clear summary of coverage, co-pays, deductibles, and authorization needs.

Real-Time Eligibility Checks

We use direct payer connections and clearinghouse tools to verify benefits in real time — not outdated cached data.

Benefits Summary Reports

Front desk receives a clear, easy-to-read benefits summary for each patient — including exact co-pay amounts and deductible remaining.

Authorization Flagging

Services requiring prior authorization are flagged immediately, giving your team time to obtain approval before the appointment.

Coordination of Benefits

Patients with primary and secondary insurance identified, and billing order confirmed to ensure correct claim routing.

Point-of-Service Collection

With accurate co-pay and deductible information in hand, your front desk can collect the correct patient responsibility every visit.

Our Process

How We Get You Paid Faster

A proven, systematic process that maximizes collections at every step of the revenue cycle.

Appointment Pull

We pull the next 2 days of scheduled appointments from your scheduling system or manually provided schedule.

Payer Verification

Direct payer portal or clearinghouse verification confirms coverage, benefits, and any authorization requirements.

Summary Report

A clear verification summary is prepared for each patient and delivered to your front desk before appointments.

Exception Alerts

Any coverage issues, authorization needs, or inactive insurance flagged immediately for your team to address.

Frequently Asked Questions

Common questions about our eligibility verification services from healthcare providers nationwide.

We verify 24–48 hours before scheduled appointments, giving your team time to contact patients about coverage issues or collect updated insurance information before they arrive.

We confirm: active/inactive coverage, plan name and group number, co-pay and co-insurance, deductible and amount met to date, out-of-pocket maximum, referral requirements, prior authorization needs, and in-network status.

Yes. We identify services on the schedule that typically require prior authorization and flag them in the summary report so your team can initiate the auth process before the appointment.

Yes. For same-day or urgent appointments, we offer expedited verification within 2–4 hours during business hours.

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