Insurance Eligibility Verification with Payers

Clinicspectrum

Starting at $14.25 per hour*

Prevent claim denials before they happen. We verify patient insurance eligibility before services are rendered, helping practices and billing companies avoid delays, rework, and lost revenue.

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HIPAA Compliant

Experienced Specialists

All Major Payors

Secure Data Handling

Verify Coverage Before the Patient Visit

Our team retrieves scheduled appointments and verifies insurance coverage in advance. Verified details are shared with your front-office or billing team before the patient visit.

See How It Works

How We Verify Insurance Eligibility

Online Payor Portals

Verification through official insurance company websites and payer portals.

Automated Voice Systems

Eligibility checks through insurance IVR systems.

Representative Calls

Direct contact with insurance representatives for detailed benefits.

RPA Bots

Automated eligibility checks using bots that interact with payer systems at scale.

AI Agents

AI-powered agents that analyze responses, validate benefits, and flag exceptions.

EDI / Real-Time Eligibility (270/271)

Real-time eligibility verification using standard EDI transactions to retrieve coverage and benefit details directly from payers.

Why Eligibility Verification Matters

Verifying coverage before appointments helps reduce denials, improve billing accuracy, and speed up payments.

Reduce Denials Now

What We Verify

  • Active or inactive coverage
  • Plan type and effective dates
  • Copays, deductibles, and coinsurance
  • Network status
  • Referral and authorization requirements

Who We Support

Medical Practices

Hospitals

Billing Companies

Telehealth Providers