Eligibility Verification

A third of denials are decided before the patient arrives.

What breaks here

Eligibility failures are the cheapest denials to prevent and among the most expensive to discover late. A terminated plan, a changed payer ID, a secondary policy nobody captured — each one produces a clean-looking claim that comes back six weeks later, sometimes near the edge of the filing window.

They also produce the other kind of damage. A patient who was told their visit was covered, and receives a bill three months later, does not blame the payer.

What we do about it

Scheduled appointments are verified in advance, typically 48 to 72 hours out, and the result comes back in a format your front desk can act on — not a raw payer response. Same-day additions are checked in real time.

Where coverage is active, we return the copay, deductible position, coinsurance and any visit limits, so the front desk can collect accurately at the point of service instead of guessing or skipping it.