Eligibility verification

Easily Verify Eligibility + Unlock Hidden Insurance Coverage

Eligibility issues are a leading cause of claim rejections, and many patients presenting as self-pay may have coverage they are unaware of. Such registration errors place an undue burden on health systems and hospitals to rework the claim and collect from patients after the point of care.

With Waystar’s Eligibility Verification and Coverage Detection solutions, you can easily find coverage your patients might not know about, verify benefits before the point of care and improve your chances of getting paid by payers and patients alike.

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The market’s most accurate eligibility verification

Waystar’s Eligibility Verification solution can automate many of the processes that go into determining what’s covered under a patient’s plan. Powered by Waystar’s Hubble AI + RPA platform, the Eligibility Verification solution automatically retrieves smart data from payers to present the most comprehensive, enriched benefit detail, all while seamlessly integrating with your health information system.

Our Eligibility Verification solution handles the toughest parts of the process, streamlining operations with features that include:

  • Benefit verification to determine eligibility and retrieve the most complete, accurate benefit response available
  • Expansive payer connectivity to ensure you have access to the most comprehensive eligibility data
  • Plan code matching that confirms the correct plan code was selected, thereby mitigating registration errors
  • Data normalization that translates and normalizes payer + EDI data to intelligently drive workflows
  • Data waterfall sequences to retrieve the most accurate and complete eligibility details
  • User alerts to escalate accounts and provide actionable next best steps for staff

Find the coverage other solutions miss

Eliminate the time-consuming process of searching for active coverage and realize immediate ROI with Waystar’s Coverage Detection solution. Our solution routinely finds active coverage for over 15% of self-pay patients, maximizing revenue opportunity, optimizing staff productivity and increasing customer satisfaction.

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See what smarter insurance verification can do for you

Waystar is one of the nation’s largest eligibility platforms and features proprietary algorithms to find and combine financial data. This means that Waystar can confirm 2.8x more coverage than the competition quickly, easily and cost-effectively. Our rapid, flexible implementation ensures you can swiftly achieve maximum benefits, while our in-house client support team continues to help you uncover new opportunities. Discover what we can achieve together. View our on-demand presentation to learn more.

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Explore further eligibility resources

Click below to learn more about our Eligibility Verification and Coverage Detection solutions, or check out our case studies to see how Waystar’s work with our clients has delivered proven results.

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