Core service
Eligibility & Prior Authorization
Coverage confirmed and authorizations secured before the visit happens — so the appointment isn't the moment you find out something was never approved.
What's included
Four commitments that keep visits from stalling.
Real-time eligibility verification
Coverage is confirmed directly with the payer ahead of the visit, so nothing downstream gets built on a lapsed or wrong plan.
Benefits and coverage breakdown
Copays, deductibles, and plan-specific exclusions are checked upfront, so patients and staff aren't surprised at checkout.
Prior authorization submission and tracking
Authorization requests are submitted with the right documentation and tracked through to a decision, not just filed and forgotten.
Auth-denial prevention reporting
Authorization-related denials are tracked back to their cause each month, so the same service stops getting delayed or denied.
How it's verified
Six steps from coverage check to confirmed visit.
Insurance Verification
Active coverage confirmed with the payer before the visit, not assumed from a card on file.
Coverage & Benefits Check
Plan-specific benefits, copays, deductibles, and exclusions pulled so the visit isn't billed against the wrong assumptions.
Prior Auth Determination
Each planned service checked against payer rules to confirm whether an authorization is required before it's scheduled.
Authorization Request Submission
Requests submitted with the clinical documentation each payer requires, formatted to their specific process.
Payer Follow-up & Status Tracking
Pending requests followed up on directly with the payer, not left to expire in a portal queue.
Approval Confirmation & Handoff
Approved authorizations confirmed and handed to scheduling and billing before the date of service.
Built for
If any of this sounds familiar, this is the right service.
- Practices with visits delayed or cancelled over eligibility surprises
- High-auth-volume specialties like imaging, surgery, or specialty procedures
- Practices seeing a rise in authorization-related denials
- Clinics that want verification handled up front, not fixed after the fact
Ready to stop losing visits to eligibility surprises?
Tell us where verification or authorization is falling through, and we'll show you what a fully checked front end looks like for your practice.
Talk to our team