Eligibility errors cost practices thousands every month.
When coverage goes unverified, the costs show up in denied claims, angry patients, and hours of staff time no one planned for.
Denied claims from missed checks
Claims denied for eligibility errors are one of the top avoidable revenue leaks in outpatient care. Each denial means a re-submission cycle that costs your billing team time and delays payment by weeks.
Staff time no one budgets for
Front-desk staff spend 10–20 minutes per patient chasing coverage details over the phone. For a busy practice, that adds up to hours every day — time pulled away from scheduling, check-in, and patient care.
Patients blindsided by bills
When deductible status or copay is wrong at check-in, patients feel misled. Disputes, delayed payments, and collection accounts follow — all preventable with an accurate pre-visit check.
How ElderberryMD handles eligibility for your practice
Our team runs verification before the visit and delivers clear coverage details — so your staff walks into check-in prepared.
We check coverage before the appointment
For each scheduled visit, ElderberryMD’s team verifies the patient’s active coverage, plan type, and in-network status with the payer — ahead of the appointment, not at the front desk.
Real-time payer checks when needed
For same-day bookings or coverage questions that arrive late, we run real-time eligibility checks directly with the payer so your team has accurate information before the patient walks in.
Coverage details delivered to your inbox
We surface the details your team actually needs: copay amount, deductible status, coordination of benefits, and any prior authorization flags — formatted for your workflow, not a payer portal.
Exceptions flagged before they become denials
When coverage is inactive, out-of-network, or requires a referral, we flag it in advance. Your team has time to address the issue before the visit rather than after the claim is denied.
What we verify for every patient
A complete eligibility check covers more than just “active or not.” We surface the details that determine what your practice actually collects.
Coverage & plan status
Active or terminated coverage, plan type (HMO, PPO, EPO), effective and termination dates, and whether the patient is in-network for your practice.
Copay, deductible & coinsurance
Current copay for the visit type, year-to-date deductible applied, remaining deductible balance, and applicable coinsurance percentages — so front desk knows what to collect at check-in.
Coordination of benefits
Primary and secondary payer order, Medicare/Medicaid crossover status, and any dual coverage that affects billing sequencing.
Prior auth & referral flags
Whether the service requires a prior authorization or referral. If flagged, our team coordinates with your prior auth workflow so the visit isn’t delayed or denied post-service.
No new systems. No new logins.
ElderberryMD integrates alongside your existing EHR and scheduling workflow. You don’t need to change how your practice operates — we fill the gaps that already exist.
Works with your existing schedule
We pull from your appointment list to run checks in advance. No manual submission or extra data entry required from your team.
Results where your team already works
Coverage details are delivered in a format your front-desk staff can act on immediately — inbox, EHR note, or workflow integration.
Included in the Pro plan
Eligibility verification is part of ElderberryMD’s full-service practice management offering for physician practices.
Pro Plan
Per practice.
- Pre-visit eligibility verification
- Real-time payer checks for same-day bookings
- Copay, deductible & coordination of benefits detail
- Prior auth and referral flags surfaced before the visit
- Exception routing to prevent post-service denials
- Works alongside your existing EHR workflow
Ready to stop chasing eligibility?
Tell us about your practice. We’ll show you how eligibility verification fits into your workflow.