Eligibility Verification Services

Catch Coverage Problems Before They Become Denials

A large share of claim denials trace back to something that could have been caught before the visit — a lapsed policy, a missed authorization, an inactive plan. We verify coverage and benefits up front so your practice isn't finding out about a problem after the claim is already denied.

Verification Checkpoints
When coverage gets checked
Live
1
Scheduling
Initial check
2
48–72 Hrs Before
Re-verification
3
Day of Service
Final confirmation
4
Pre-Claim
Last check before billing
Verification Impact Commonly cited industry data
44%
of denials originate at the front end of the revenue cycle — scheduling, registration, and pre-service verification.
~24%
of denied claims have been attributed to eligibility or registration issues alone.
Why It Matters

Why Eligibility Verification Deserves a Real Process

A coverage problem caught before service is a quick fix. The same problem caught after a denial means rework, delay, and sometimes an unrecoverable balance.

Fewer Front-End Denials

The most common category of denial is addressed before a claim is ever filed.

Accurate Patient Estimates

Patients get a clearer picture of what they'll owe before service.

Faster Collections

Clean, verified claims move through payers with less back-and-forth.

Less Rework

Catching issues early means less time spent correcting and resubmitting.

Services

Our Eligibility Verification Services

Coverage confirmed at every point where it matters, not just once.

Coverage & Benefits Verification

Active coverage, plan limits, copays, and deductibles are confirmed before service.

Authorization & Referral Checks

Services requiring prior authorization or a referral are flagged before the visit.

Re-Verification Before Service

Coverage is re-checked close to the appointment date, since plans can change.

Pre-Claim Final Check

A last confirmation before the claim goes out, catching anything that shifted.

Why Claimza

Why Practices Rely on Claimza for Verification

Coverage checked at multiple points, not just once at scheduling
Authorization and referral requirements flagged before service
Clear communication when a coverage issue is found
Fewer front-end denials reaching the claims stage
HIPAA-conscious handling of patient and coverage data

Stop Losing Revenue to Preventable Coverage Issues

Let's look at how eligibility is currently being checked in your workflow — and where gaps might be costing you denials.

+1 786 735 2873 · info@claimzasolutions.com

FAQ

Eligibility Verification FAQs

Active coverage status, plan benefits, copay and deductible amounts, plan limits, and whether the service requires prior authorization or a referral.

Ideally at multiple points — when the visit is scheduled, again 48-72 hours before, and a final check on the day of service or before the claim is submitted, since coverage can change.

Yes. Eligibility and front-end registration issues are consistently cited as one of the largest categories of preventable claim denials industry-wide.

You're notified before the visit or claim submission so the issue can be addressed — whether that's confirming updated coverage, obtaining an authorization, or discussing options with the patient.

Yes, verification is performed across commercial, Medicare, Medicaid, and other payer types your practice works with.

No. Returning patients' coverage can change too — plan switches, lapsed policies, and new authorization requirements are common even for established patients.