Eligibility verification: catch problems before the visit

Some of the most common denials are entirely knowable before the patient is even seen. Checking eligibility up front is one of the most valuable steps in the whole cycle.

4 min read

What verification confirms

Verifying eligibility means confirming that coverage is active and understanding the benefit details before the visit. That includes checking whether the plan has changed or ended, and whether a referral or authorization may be needed.

Why timing is everything

A coverage problem found after the claim is denied is expensive to fix. The same problem found before the visit can often be solved with a phone call, or at least explained to the patient up front.

Checking early is also better for patients, because what they owe does not come as a surprise later.

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The common reasons claims are denied, and the upstream steps that stop them recurring.