Insurance Eligibility Verification
Pre-visit verification of coverage, co-pays, deductibles, and authorization requirements — eliminating billing surprises and stopping denials before they start.
What we handle
- Real-time eligibility and benefits checks
- Co-pay, deductible, and coinsurance details
- Prior authorization requirements flagged
- Coverage confirmation before each visit
- Patient-responsibility estimates up front
Why it matters
Eligibility errors are a leading cause of denials — and the easiest to prevent. Verifying before the visit protects both your collections and the patient experience.
How ERG delivers
We verify eligibility ahead of the schedule and flag issues for our team to resolve, so front-desk staff and patients both know what to expect.
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Questions about this service
What information is included in an eligibility check?
The check may include active coverage, payer order, network status, deductible, copay, coinsurance, visit limits and referral or authorization indicators available from the payer.
Does eligibility verification guarantee payment?
No. It reduces avoidable front-end errors, but payment still depends on coverage, documentation, coding, medical necessity, authorization and payer adjudication.
When should eligibility be verified?
Verify before the service and repeat when the appointment date, coverage, payer order or planned service changes.
Can ERG also support prior authorization?
Prior authorization support can be included as a separately defined workflow covering submission, status follow-up, documentation requests and communication of the payer's decision.