Patient Eligibility Verification

Stop denials before the patient walks in.

Same-day insurance eligibility verification for U.S. medical practices. We confirm coverage, benefits, copays, deductibles, and prior auth requirements across every major commercial and government payer. Your front desk gets a clean plan, your billers get clean claims.

0+
Years running
0+
U.S. states served
0+
Specialties billed
HIPAA
Compliant workflows
SOC 2
Type II aligned
27%
Of denials start at intake
Not at billing
$25+
Cost to rework each denied claim
Not counting the delay
80%
Front-desk verification time saved
When done right
What We Check

Six things verified for every patient, every visit.

Not just a yes or no on coverage. The complete picture your front desk and billers need to actually get paid.

Active Coverage

Confirm the policy is active on the date of service. Terminated coverage caught before the visit, not after.

Benefit Details

What services are covered, at what percentage, and any specialty carve-outs for your CPT codes.

Copay & Deductible

Current copay, deductible remaining, and out-of-pocket max. Your front desk can collect at check-in, not chase later.

Prior Authorization

We check whether prior auth is required for planned services and initiate the process if needed.

Secondary Insurance

Both primary and secondary coverage verified. Coordination of benefits handled before billing.

Referral Requirements

HMO plans that need referrals flagged early so your team can secure them before the appointment.

How It Works

Real-time verification, delivered to your front desk.

You send the schedule. We do the work. Your team sees clean verification results inside their existing workflow.

Every Morning

Schedule Received

We pull tomorrow’s appointment list from your PM system. New patients, follow-ups, and procedures.

Real-Time

Verification Runs

Electronic eligibility checks with each payer. Complex plans and secondaries handled by our verification specialists.

Same Day

Results Delivered

Clean verification report inside your PM system before the patient walks in. No PDF back and forth.

At Check-In

Clean Intake

Front desk sees exact copay to collect, deductible remaining, and any prior auth flags. No guessing.

Payer Coverage

Every payer your patients carry.

Commercial, government, workers comp, and specialty. Real-time where the payer supports it, manual verification where it doesn’t.

Aetna
BCBS
Cigna
UnitedHealthcare
Humana
Medicare
Medicaid
TRICARE
Workers Comp
Veterans Affairs
Kaiser
50+ Regional

Don’t see your payer? We handle every payer that operates in the U.S. Just ask.

80%
Front-desk time saved
On verification alone
“Our front desk used to spend two hours every morning on the phone with insurance companies. Now they walk in and the verification is already done. Denials from eligibility issues dropped from twenty-three a month to three. That’s real money.”
PA
Practice AdministratorCardiology Group, Florida
Frequently Asked Questions

Common questions about eligibility verification.

What is patient eligibility verification?

Patient eligibility verification is the process of confirming a patient’s insurance coverage, benefits, copays, deductibles, and prior authorization requirements before the patient is seen. Done well, it stops most denials at the front door instead of after the claim is filed.

How long does verification take?

Real-time electronic verification takes seconds. Manual verification for complex plans or secondary insurance usually takes 5 to 15 minutes. We turn around same-day requests within two business hours.

Which payers do you verify with?

All major commercial payers including Aetna, BCBS, Cigna, UnitedHealthcare, and Humana. Medicare, Medicaid across all fifty states, and specialty payers including workers compensation, TRICARE, and Veterans Affairs.

Do you handle prior authorization?

Yes. We flag services that require prior auth during verification and initiate the process if you want us to. Approved auths land back in your PM system with the auth number and expiration date attached.

How does verification data reach my front desk?

Directly inside your existing PM system. Athena, eClinicalWorks, Kareo, DrChrono, AdvancedMD, NextGen, and most others. No new logins, no PDF back and forth. Your front desk sees the results where they already work.

Can you verify for new patients before we schedule them?

Absolutely. Many practices run a quick eligibility check when scheduling a new patient so you know their financial responsibility before the visit. We can turn these around in about an hour during business hours.

Ready to stop denials before they start?

Send us a week of your appointment schedule. We’ll run verifications alongside your current process and show you exactly what you’ve been missing. Free, no obligation.