Front of cycle
Stop denials before the patient is seen
Eligibility and benefits verified ahead of the visit, authorizations tracked, and coverage confirmed while there is still time to do something about it. The cheapest denial is the one that never happens.
Eligibility is where denials are born
Front-end failures are the largest single source of denied claims. In a 2025 provider survey, missing or inaccurate data drove 50% of denials and incomplete or inaccurate patient registration data drove 32% — both up year over year (Experian Health, 2025). A separate MGMA poll of 235 medical groups named patient eligibility issues and incorrect ID numbers among the top causes of rising denials (MGMA, 2024).
The economics are lopsided. Verifying coverage takes minutes at the front desk. Appealing the resulting denial takes weeks, costs materially more per claim, and still may not get paid. Hospitals spent an average of $57.23 per claim fighting through adjudication in 2023, up 23% in a single year (Premier Inc., 2025).
Then there is prior authorization, which has become its own operational burden. Physicians average 40 prior authorizations a week, consuming 13 hours of physician and staff time, and 40% of practices now employ staff who work exclusively on it (AMA, 2026).
- Eligibility and benefits verified ahead of scheduled visits
- Active coverage, plan type, and effective dates confirmed at source
- Patient financial responsibility identified before the visit, not after
- Prior authorization requirements flagged, submitted and tracked to decision
- Registration and demographic data checked against payer records
- Coordination of benefits and secondary coverage identified upfront
- Referral requirements confirmed where the plan demands them
How it works
What we actually do
We verify ahead of the schedule
Verification runs against upcoming appointments rather than reacting at check-in, so there is time to resolve a coverage problem before the patient is standing at the desk.
Discrepancies come back to your team, clearly
When coverage is inactive, the plan has changed, or the ID does not match, your front desk gets a specific, actionable note — not a raw payer response to interpret.
Authorizations are tracked to a decision
Submitted, followed up, and escalated. Under CMS rule CMS-0057-F, affected payers must decide standard prior authorization requests within seven calendar days from January 2026 and give a specific reason for every denial. We hold them to it.
Patterns get reported, not just handled
If one payer keeps rejecting a particular plan type or a specific registration field keeps causing denials, that shows up in your reporting as a fixable pattern.
Common questions
What practices ask us about this
Does this replace our front desk staff?
How far ahead do you verify?
Do you handle prior authorizations too?
What about patients who arrive same-day?
Will patients get a cost estimate?
Related services
The rest of the cycle
Find out what your revenue cycle is actually leaving behind.
Request a consultation and a revenue cycle specialist will walk through your denial patterns, A/R aging and payer mix with you. No obligation, and no software to install.