CoreMedX Health

Eligibility Verification

Verify Before You Treat

We verify patient insurance coverage, co-pays, deductibles, and eligibility details before appointments take place. This helps practices avoid claim issues, improve billing accuracy, and create a more seamless experience for both staff and patients.

ELIGIBILITY VERIFICATION

Verify Before the Visit. Every Time.

We verify every patient’s insurance eligibility 24 to 48 hours before their appointment confirming active coverage, co-pay, deductible balance, coinsurance, and network status across 900+ payers in real time.

Any discrepancy triggers an immediate alert to your front desk with the exact issue and corrected information before the patient arrives, not after.

BENEFITS AT CHECK-IN

Tell Patients What They Owe Before They Ask.

Every verification includes a plain-language summary showing the patient’s remaining deductible, co-pay for the visit type, coinsurance percentage, and out-of-pocket maximum progress ready for your front desk to communicate at check-in.

Practices that use verified benefits data at time of service collect 34% more patient responsibility upfront reducing statements and reducing bad debt.

900+ PAYER CONNECTIONS

One Query. Full Benefits. Under 60 Seconds.

Our platform connects to 900+ payers through direct EDI 270/271 and API integrations returning a complete eligibility response including coverage status, copay by service type, deductible, coinsurance, and prior auth flags in under 60 seconds.

Results are delivered in plain language to your front desk not raw EDI output. Staff see exactly what the patient owes before the visit begins.

01

Denial Reviewed : Reason identified and appeal pathway determined within 4 hours.

02

Appeal Filed : Full clinical documentation submitted within 24 hours..

03

Coordinated : P2P Call scheduled, talking points prepared, payer logistics handled.

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