Service 4 of 9
Eligibility & verification
Confirms coverage, carrier and adjuster before the bill goes out.
- Payors
- Providers
How it runs
AI-led: 2 of 4 steps
AI + person-led: 1 of 4 steps
Person-led: 1 of 4 steps
- Checks coverage through payer portals and electronic eligibility AI
- Matches employer, carrier and date of injury to the claim AI
- Contacts the adjuster and employer when records conflict Person
- Logs each verification with its source for audit AI + person
Always reserved for a person: When records conflict, a person calls the adjuster.
Who it is for
- Payors who want fewer surprise bills on claims they do not cover
- Pharmacies and practices billing workers' comp and auto claims
- Employers and adjusters asked to confirm a claim
How it connects
- Invoicing & billing: Bills go to the payer that was actually confirmed.
- Prior authorization: Authorization requests start from verified coverage.
- Help desk: Callers asking about coverage get the verified answer.
What gets measured
The numbers we report to you.
Targets are agreed with each client, per task. We report against them, and automation is held to historical human accuracy.
- Verified before billing Claims confirmed before the first bill.
- Time to verify From a new claim to a confirmed carrier and adjuster.
- Billed-to-wrong-payer rate Bills returned because coverage was wrong.
- Audit trail Every verification stored with its source.
Next service: Invoicing & billing →
Talk to us
Talk to us about eligibility & verification.
We'll show you how we'd run it: what AI would handle, where your team or ours would decide, and what we'd measure.
Talk to us- Pharmacy help desk · Workers' comp
- 844.328.2048
- Pharmacy help desk · Auto no-fault
- 844.569.8876
- helpdesk@health-lift.com
- Billing address
- PO Box 520190, Salt Lake City, UT 84152