Patient Insurance Eligibility Verification Software
Know What’s Covered Before You Treat
Verify patient insurance eligibility, confirm active coverage, validate CPT coverage, and collect accurate co-pays – all before the patient walks in the door.
From Scheduling to Check-In, Fully Automated
Replace manual verification steps with an intelligent, automated workflow by our insurance eligibility verification software that protects revenue at every touchpoint.
Patient Schedules an Appointment
Appointment is booked in zHealth and insurance details are captured or confirmed.
Automated Insurance Eligibility Verification Before the Visit
Fill out the details of the patient and CPTs, zHealth instantly queries the payer to confirm active coverage, plan type, and policy status.
Coverage Is Confirmed Before the Visit
zHealth’s insurance eligibility verification software validates whether the scheduled procedure codes are covered under the patient’s specific plan.
Patient Responsibility Is Calculated
Deductibles, co-pays, and co-insurance are surfaced automatically, so staff knows exactly what to collect.
Confident, Accurate Check-In
Staff collects the correct amount at time of service. No surprises for the patient, no revenue risk for the practice.
Real-Time Patient Insurance Eligibility Verifcation
When you verify upfront, you protect revenue downstream. Here’s what that looks like in practice with zHealth patient eligibility verification software.
Faster Eligibility Verification
Confirm whether a patient’s insurance policy is active, lapsed, or terminated, directly from the payer, at the time of visit or check-in.
CPT Code Coverage Validation
Check whether the specific CPT codes for a patient’s scheduled services are covered under their plan before treatment begins. Eliminate denials caused by non-covered services.
Deductibles & Co-Pay Visibility
See remaining deductibles, co-insurance amounts, and patient co-pay obligations at a glance. Collect the right amount at check-in, every time.
Insurance Benefits Detail
Access a comprehensive breakdown of the patient’s plan benefits, visit limits, referral requirements, and in-network/out-of-network details in one place.
Automated Verification at Scheduling
Trigger eligibility checks automatically when an appointment is booked, so your team arrives to check-in with coverage already confirmed, not questions still open.
Multi-Payer Connectivity
Connect to hundreds of insurance payers through a single integration. No more logging into multiple portals or sitting on hold with insurance companies.
Patient Insurance Verification Is a Revenue Strategy, Not Just Admin
When you verify upfront, you protect revenue downstream. Here’s how our insurance eligibility verification software looks like in practice.
✓ Fewer Claim Denials: Stop denials before they happen by confirming coverage and CPT code eligibility prior to treatment.
✓ Collect More at Point of Care: Accurate co-pay data means you collect the right amount upfront, reducing patient balance follow-up.
✓ Faster Reimbursements: Clean claims with verified coverage submit correctly the first time and get paid faster.
✓ Reduced Billing Staff Workload: Automation handles verification at scale, freeing your team to focus on patient experience and exceptions.
✓ Improved Insurance Acceptance: Confidently accept more insurance plans knowing you can verify coverage and collect accurately every time.
FAQs On Patient Insurance Eligibility Verification Software
What is insurance eligibility verification?
EHR insurance eligibility verification is the process of instantly querying a patient’s insurance payer to confirm their current coverage status, plan details, deductibles, co-pays, and co-insurance amounts. Unlike batch checks done overnight, real-time verification happens at the moment of inquiry, giving your team accurate, up-to-date information before or during check-in.
How does CPT code coverage verification work?
CPT (Current Procedural Terminology) code verification checks whether the specific procedure codes planned for a patient’s visit are covered under their insurance plan. zHealth submits the CPT codes to the payer during the eligibility check, and the system returns whether those codes are covered, excluded, or subject to limitations like prior authorization, before you render the service.
Can zHealth verify eligibility for multiple insurance payers?
Yes. zHealth’s EHR system comes with online eligibility verification software connects to hundreds of commercial and government insurance payers through a single integration. You don’t need to log into individual payer portals or maintain separate credentials. Whether your patients carry BCBS, Aetna, United, Cigna, Medicare, Medicaid, or other plans, verification happens within the same workflow.
Is zHealth's real-time eligibility software suitable for chiropractic practices?
Absolutely. zHealth was purpose-built for chiropractic and allied health practices. Chiropractic billing involves specific CPT codes, visit limits, and plan restrictions that vary widely across insurers. The eligibility system is designed to handle these nuances, confirming chiropractic-specific coverage, visit counts remaining, and applicable CPT codes before every appointment.
What information does an eligibility verification response include?
With zHealth’s real time eligibility check, a typical eligibility response includes: policy status (active/inactive), plan name and type, effective and termination dates, deductible amounts and how much has been met, co-pay and co-insurance details, out-of-pocket maximum, covered services and exclusions, CPT code-level coverage when queried, and any referral or prior authorization requirements.
How does electronic eligibility verification improve the patient experience?
When patients know what their insurance covers and what they owe before their appointment, they arrive prepared and encounter no billing surprises. This financial transparency builds trust, reduces front-desk conflict, and improves patient satisfaction, while also improving collection rates since patients are more likely to pay amounts they understood and expected.
Ready to Stop Guessing and Start Verifying?
See how zHealth’s patient eligibility verification software can reduce denials, speed up payments, and give your front desk confidence on every check-in.
