Eligibility and Benefits Verification for Medical Practices
Many preventable denials start before the patient arrives: coverage that changed after scheduling, a visit limit already reached, or an authorization requirement nobody caught. Medalyze verifies eligibility and benefits close to the date of service, so your front desk and billing team work from accurate information.
What we verify
Active coverage
We confirm the patient's coverage is active for the date of service.
Plan and network status
We confirm the plan and whether your practice is in network.
Copays, deductibles and coinsurance
Patient cost-share is recorded so your front desk can collect accurately.
Visit limits
We check whether a visit limit has already been reached.
Authorization requirements
We identify authorization requirements before the visit, so nothing is missed.
Complete answers, recorded before the visit
We confirm active coverage, plan and network status, copays, deductibles and coinsurance, visit limits and authorization requirements. When an electronic eligibility response is incomplete, our specialists, supported by our eligibility-verification calling agents, follow up with the payer until the answer is complete. Results are recorded before the visit, and exceptions are flagged for your team.