A Clean Claim Can Still Get Denied Because Nobody Checked Coverage

Your dedicated OmniMD Eligibility Verification Coordinator catches every coverage gap, authorization miss, and COB error 48 hours before the appointment, long before it costs you anything.

Protect My Revenue Up Front
A Clean Claim Can Still Get Denied Because Nobody Checked Coverage 1

98.6%

First-Pass Rate

72%

Of Eligibility Denials Are Preventable

Dedicated Coordinator

Dedicated Coordinator

Insurance Eligibility Verification That Goes Further Than Any Portal Ever Could

Real Time Clearinghouse Verification

Real-Time Clearinghouse Verification

A direct electronic query to the payer, not a portal lookup, not a phone call. Active coverage, deductible balances, co-pay by service type, network status, coordination of benefits data, and authorization flags are all documented in your practice management system before the appointment and resolved if anything is wrong while there is still time to act on it.

Complete Breakdown of Benefits

Complete Breakdown of Benefits

Active or inactive tells you almost nothing useful on its own. Your coordinator captures everything: what the plan covers for the specific service scheduled, where the patient stands on their deductible, what they owe at the visit, visit limits, exclusions, and out-of-pocket maximums. No surprises at checkout and no Explanation of Benefits that contradicts what the patient was told when they walked in.

Prior Authorization Confirmed Against Todays Rules

Prior Authorization Confirmed Against Today’s Rules

Authorization requirements shift by payer, procedure, and quarter, often without any formal notice to your practice. Your coordinator checks current requirements for every scheduled encounter and secures what is needed before the visit. When a payer closes its retroactive authorization window, practices that verified in advance are protected. Practices that did not are left with no recourse.

Coordination of Benefits Locked In Before the Claim Is Touched

Coordination of Benefits Locked In Before the Claim Is Touched

A sequencing error on coordinated benefits generates simultaneous denials from two payers at once, and untangling that is a far harder problem than preventing it. Your coordinator establishes primary and secondary coverage, documents the correct sequencing, and routes everything to the claims team before the encounter is coded. Prevention, not recovery.

Here’s What Gets Verified

Active coverage as of the date of service

In-network vs. out-of-network benefit levels

Deductible balances (individual and family)

Co-pay by service type and co-insurance percentage

Prior authorization under current payer policy

COB sequencing (primary and secondary confirmed)

Visit limits, exclusions, and benefit caps

Out-of-pocket maximum and remaining patient responsibility

Policy effective and termination dates

Referral requirements for specialist visits

Heres What Gets Verified

Why Leading Practices Are Rethinking How Eligibility Verification Gets Done

72%

Of eligibility denials are preventable before the appointment even happens

48 hours

Of lead time turns a coverage crisis into a five-minute fix

tick-mark-97%

97%

Of eligibility denials we appeal are successfully recovered and paid

scheduled patients

100%

Of scheduled patients verified before a single claim is touched

$0

Of eligibility denials are preventable before the appointment even happens

1

1 dedicated coordinator Accountable for your entire front-end revenue protection

Your Cleanest Claims Are Still Getting Denied. Let’s Fix That at the Source.

Start Verifying Before the Visit

Frequently Asked Questions

It is the process of confirming a patient’s active coverage, benefits, deductibles, and authorization requirements before the appointment happens. Without it, your practice is essentially filing claims blind and finding out about coverage problems after the denial, when it is already too late to do anything useful about them.

Because it catches coverage problems while there is still time to fix them. A lapsed policy found 48 hours before the appointment is a quick patient call. The same problem found after the claim is denied is an appeals process that may not recover anything.

Eligibility verification tells you whether the policy is active. Benefits verification tells you what it actually covers for the scheduled service, what the patient owes, and where they stand on their deductible. You need both to file a clean claim with any confidence.

Your coordinator queries the payer’s live enrollment data 48 hours before the visit, documents the complete coverage detail in your practice management system, and resolves anything that needs fixing before the patient walks in.

Because a dedicated coordinator accountable for your denial rate approaches eligibility verification very differently than a front desk employee checking a portal between patient arrivals. Accountability changes everything about how thoroughly it gets done.

Lapsed coverage, missing prior authorization, incorrect coordination of benefits sequencing, and unverified deductible balances. Every one of these is preventable with a structured pre-authorization eligibility check done far enough in advance to act on what is found.