Coverage failures found after the encounter are the most expensive kind, because the service is already delivered. Most of them were visible beforehand — an inactive plan, a met visit limit, an authorization nobody requested.
You know what a visit is covered for before it happens, and the patient hears an accurate number rather than a hopeful one.
At a glance
Step 1
Run electronic eligibility ahead of the visit
Step 2
Perform full benefits investigation where the detail matters — deductible, coinsurance, limits, authorization requirements
Step 3
Call the payer when the portal will not answer the question
Step 4
Identify secondary coverage the patient did not mention
What we actually do
- Run electronic eligibility ahead of the visit
- Perform full benefits investigation where the detail matters — deductible, coinsurance, limits, authorization requirements
- Call the payer when the portal will not answer the question
- Identify secondary coverage the patient did not mention
What this fixes
- Coverage confirmed weeks earlier and assumed still true
- Estimates given to patients from an eligibility check that never included benefits
- Secondary coverage discovered only after the balance became patient responsibility
We keep the books. You run the business.
Categorization, reconciliation, month-end close, and clean financial statements — with nothing left for you to chase.
View pricingHow It Works
Review
We look at how this runs today and where it leaks.
Scope
A written scope and price before any work starts.
Transition
We take it over without a gap in submission.
Report
The same six numbers every month, so you can see it working.
Eligibility & Benefits Verification — Frequently Asked Questions
Is an eligibility check the same as a benefits verification?
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No, and the difference is the whole point. One confirms coverage is active; the other establishes what it actually pays for. They are priced separately because they are different work.
How often should Medicaid eligibility be checked?
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Every visit. Medicaid coverage churns month to month in a way commercial coverage does not.
Ready for books you can actually trust?
Book a free consultation and we will tell you what your books need and what it costs.
- Done-for-you
- Solo or group
- Nationwide
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