Insurance Eligibility
Verification Services
We confirm coverage before the appointment, so claims don’t get denied over problems that were preventable.
Catching Coverage Problems Before They Become Denials
A large share of denials trace back to something that could’ve been caught before the visit inactive coverage, an unmet authorization requirement, a plan that changed without notice. We verify eligibility and benefits ahead of scheduled services, so your front desk isn’t finding out about a coverage problem after the claim’s already been submitted.
Verification Built Into Your Scheduling Workflow
We check eligibility, benefits, and authorization requirements ahead of the appointment — not as an afterthought, but as a standard step before a patient is seen.
Real-Time Answers, Not Outdated Coverage Data
Coverage changes — patients switch plans, employers change carriers, benefits reset. We verify directly with payers close to the appointment date, rather than relying on information that may already be stale.
Our Verification Process
A structured process for confirming coverage before the patient walks in.
Schedule Review
We check upcoming appointments against current insurance information on file.
Eligibility & Benefits Check
We verify active coverage, plan details, and benefit levels directly with the payer.
Authorization Confirmation
We confirm whether the scheduled service requires prior authorization, and whether it's in place.
Discrepancy Flagging
Any coverage issue is flagged to your front desk before the appointment, not after.
Documentation
Verification results are documented and available for reference at the time of billing.
Common Eligibility Problems We Help Solve
- High rate of denials due to inactive or lapsed coverage
- Limited front-desk staff capacity to verify every appointment
- Confusing, plan-specific benefit and authorization requirements
- Late eligibility discovery leading to delayed cash flow
- Patients switching plans without notifying the practice
- Manual, time-consuming verification through calls and payer portals
What Our Customers Say
Clients Testimonials
FAQS
Frequently Asked Questions
How far in advance do you verify insurance before an appointment?
We typically verify 24–48 hours ahead of the scheduled appointment, close enough to catch last-minute plan changes but early enough to give your front desk time to address any issues before the patient arrives.
What happens if you find a coverage problem before the appointment?
We flag it to your front desk right away, along with what we found — inactive coverage, a missing authorization, a benefit limitation — so it can be addressed before the visit instead of after the claim is denied.
Do you handle prior authorization, or just eligibility checks?
We confirm whether a scheduled service requires prior authorization and whether one is already in place. If authorization still needs to be obtained, that’s coordinated as part of the verification process.
Can this reduce our denial rate even if our coding and billing are already accurate?
Yes — a meaningful share of denials come from eligibility issues that have nothing to do with coding or billing accuracy. Catching those upfront prevents a category of denials that clean claims can’t avoid on their own.
Stop Denials Before They Start
The cheapest denial to fix is the one that never happens. Book a free consultation and we’ll show you how upfront verification protects your claims.
