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What is Insurance Verification Automation?

Insurance verification automation instantly checks patient eligibility, benefits, and coverage details in 2-5 seconds instead of 15+ minutes. It connects directly to 500+ payers including VSP, EyeMed, and Medicare to provide real-time coverage information.

Key Benefits:

  • Reduces verification time by 99%
  • Prevents 75% of eligibility denials
  • Saves 3+ hours daily per practice
  • Covers 500+ insurance payers
Save 3+ hours daily on insurance verification

Insurance Verification inSeconds, Not Minutes

Stop losing $85,000+ annually to eligibility denials. Our AI instantly verifies coverage, benefits, and authorizations for 500+ payers—eliminating surprises and accelerating payments.

The True Cost of Manual Verification

23%
Claims denied
For eligibility issues
15 min
Per verification
Manual process
$85K
Annual loss
Revenue impact
38%
Info incomplete
Missing benefits

From 15 Minutes to 15 Seconds

Real-time verification that actually works

1

Patient Checks In

System automatically triggers verification using patient ID and insurance info from your PMS

2

Instant Verification

AI queries payer systems, verifies eligibility, pulls benefits, checks deductibles—all in seconds

3

Ready for Service

Complete coverage details appear in your system. Staff knows exactly what's covered before exam starts

Complete Coverage Intelligence

Every detail you need, instantly available

Real-Time Eligibility

  • Active/inactive status
  • Effective dates
  • Plan type & tier
  • Primary/secondary coverage

Benefits Breakdown

  • Copay amounts
  • Deductible status
  • Out-of-pocket max
  • Remaining benefits

Vision Plan Details

  • Exam frequency
  • Materials allowance
  • Contact lens coverage
  • Frame benefits

Prior Authorization

  • Auto-submission
  • Status tracking
  • Approval alerts
  • Required documentation

Coordination of Benefits

  • Multiple coverage check
  • Primary/secondary rules
  • Medicare coordination
  • Split billing guidance

Historical Tracking

  • Coverage changes
  • Benefit utilization
  • Last exam dates
  • Claims history

500+ Payers, One Integration

Direct connections to all major vision and medical plans

Vision Plans

  • VSP Vision Care
  • EyeMed Vision Care
  • Davis Vision
  • Spectera/UnitedHealthcare
  • Superior Vision
  • Humana Vision

Medical Plans

  • Medicare/Medicare Advantage
  • Blue Cross Blue Shield
  • UnitedHealthcare
  • Aetna
  • Cigna
  • Anthem

Regional & Others

  • State Medicaid Programs
  • Kaiser Permanente
  • TRICARE
  • Workers' Compensation
  • Local HMOs/PPOs
  • 450+ more...

The Verification Transformation

Manual Verification Hell

  • 15+ minutes on hold per call
  • Multiple portals to check
  • Incomplete information captured
  • Benefits misunderstood
  • Surprise denials after service
  • Patient dissatisfaction
  • Staff burnout from repetitive tasks

Cost: $85,000+ lost annually

Automated Intelligence

  • Instant verification at check-in
  • All payers in one system
  • Complete benefits breakdown
  • Clear coverage explanations
  • Pre-service financial clarity
  • Happy, informed patients
  • Staff focused on patient care

Result: $85,000+ recovered annually

ROI Calculator: Insurance Verification

For a practice seeing 30 patients daily

Time Savings

Manual verification time:

15 min × 30 patients = 7.5 hours/day

Automated verification:

Instant (0 hours)

Staff hours saved: 1,875 hours/year = $56,250 value

Revenue Recovery

Eligibility denial reduction (75%)+$63,750
Missed copay collection+$12,000
Prior auth approvals+$9,250
Total Annual Value+$141,250

3,924% ROI • Pays for itself in 2 days

Proven Verification Success Metrics

Results from practices using automated verification

93%

Reduction in Eligibility Denials

Practices typically see eligibility-related denials drop from 23% to under 3% within the first month of implementation.

Time savings justify cost immediately

3+ hrs

Daily Time Saved

Staff reports elimination of phone calls to insurance companies. Verification that took 15 minutes now happens instantly at check-in.

Staff can focus on patient care

$92K

Average Annual Recovery

Between reduced denials and captured copays, practices recover significant revenue. VSP and EyeMed automation particularly impactful.

ROI achieved within first week

Common Questions

How fast is the verification really?
Most verifications complete in 2-5 seconds. Complex cases with multiple coverages might take up to 15 seconds. Compare that to 15+ minutes on the phone, and you're looking at a 99% time reduction.
What if a payer isn't in your network?
We cover 500+ payers including all major vision and medical plans. For the rare unsupported payer, our system flags it immediately so staff can verify manually—still saving time on 95%+ of verifications.
How accurate is the benefits information?
We pull data directly from payer systems in real-time, achieving 99.7% accuracy. This is actually more accurate than phone verification since there's no human transcription error.
Does it handle vision plan complexities like VSP?
Yes! We've built specific logic for VSP, EyeMed, and other vision plans. The system understands frequency limitations, frame allowances, contact lens benefits, and coordinated benefits automatically.
Can it submit prior authorizations?
Yes. The system can automatically submit prior auth requests when needed, track their status, and alert you when approved. It knows which procedures require auth for each payer.
What about patient privacy and HIPAA?
We're fully HIPAA compliant with enterprise-grade security. All verifications are logged for audit trails, data is encrypted at rest and in transit, and we exceed healthcare security standards.

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* All metrics and savings shown are based on industry averages and potential improvements. Individual results may vary.