What moves forward.
The order, authorization and claim use a reviewed payer context.
Payers, insurance & eligibility
A payer name is not an electronic payer identifier, and an active plan does not establish that a particular item is payable.
THE OPERATING FLOW
What your team does.
- Resolve the carrier and plan type; review uncertain matches.
- Confirm patient identifiers and the intended transaction.
- Run an enabled eligibility check and retain its dated result.
When something changes.
A rejection returns to the carrier mapping, member identifier, date and enrollment evidence.
CONTROL POINT
Keep the evidence attached and make the missing information visible.
YOUR IMPLEMENTATION
Eligibility uses a configured provider and may incur usage charges. Benefits responses are not a payment guarantee.
Your operation. Your scope.See what changes
See what changes
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Selected modalities · agreed AI allowance
BAA and setup before patient data