HealOS verifies patient insurance coverage instantly with automated eligibility checks, real-time benefit extraction, and continuous insurance monitoring, reducing denials, eliminating manual work, and improving clean-claim rates for every visit.
Manual eligibility verification is slow, error-prone, and costly. Teams spend hours on phone calls, portal navigation, and data entry—leading to denials, delayed care, and lost revenue. HealOS transforms this with AI-powered automation.
| Challenge | Impact | HealOS Solution |
|---|---|---|
| Manual eligibility verification | Slow, error-prone, time-consuming | Automated real-time eligibility checks in seconds |
| Expired or inactive coverage | Claim denials, lost revenue | Continuous insurance monitoring & alerts |
| Missing authorization requirements | Preventable denials (~25% of all denials) | AI extracts PA requirements upfront |
| Portal access limitations | Incomplete verification data | Voice-enabled AI calls insurers directly |
| High labor costs | Expensive manual verification processes | 75% reduction in labor costs with automation |
Our AI-driven platform delivers measurable improvements in revenue accuracy, denial reduction, and operational efficiency, empowering healthcare organizations to verify coverage faster and more reliably at every step of the revenue cycle.
HealOS automates benefit checking, payer portal navigation, insurance monitoring, and real-time coverage extraction for every patient encounter.
Voice AI calls insurers automatically to verify eligibility, extract benefits, and confirm coverage details, even when payer portals are slow, restricted, or unavailable, ensuring complete data without manual phone work.
HealOS validates patient coverage instantly at check-in, scheduling, or during documentation, delivering real-time confirmation of active status, deductible amounts, copays, and authorization requirements in seconds.
Process thousands of eligibility checks simultaneously with automated batch workflows. Perfect for high-volume clinics, multi-specialty groups, and health systems needing rapid verification before daily patient visits.
Connects with Availity, Waystar, and major payer portals to retrieve the latest eligibility data. API access ensures all benefits, co-pays, and coverage limitations are always accurate and current.
AI learns from payer patterns, identifies discrepancies, predicts plan issues, and flags eligibility risks before claims are submitted, reducing downstream denials and improving claim acceptance on the first pass.
HealOS integrates with Epic, Cerner, Athena, NextGen, AdvancedMD, and more. Eligibility results sync directly into charts, claims, and billing workflows for zero data entry and error-free transitions.
AI extracts full coverage details, copays, deductibles, out-of-pocket max, coinsurance, effective dates, limitations, exclusions, and prior authorization requirements, feeding clean data directly into your RCM system.
HealOS checks state Medicaid portals continuously and updates coverage changes instantly. Automated workflows handle redetermination issues, inactive coverage, or provider mismatches without manual effort.
AI seamlessly handles logins, One Healthcare ID, ID.me, and Multi-Factor Authentication for complex payer portals, allowing uninterrupted access to eligibility information while maintaining strict HIPAA compliance.
Process up to 300 eligibility checks per minute with enterprise-grade automation. HealOS scales effortlessly for large clinics, hospitals, and multi-location networks without adding administrative staff.
HealOS uses AI, RPA, API connections, and voice-enabled automation to verify coverage instantly, ensuring accurate, complete eligibility data before every patient encounter.
HealOS pulls policy numbers, plan IDs, demographics, and card details from your EHR, scheduling system, or scanned insurance card using OCR and AI-driven data extraction.
AI bots log into payer portals or call payer APIs to retrieve real-time eligibility details, bypassing manual portal navigation, long wait times, or human error.
Within seconds, HealOS confirms eligibility status, plan coverage, deductible amounts, active periods, and authorization requirements before services are delivered.
AI identifies coverage limitations, copays, coinsurance, prior authorization needs, and referral requirements, ensuring claims are submitted the first time.
If coverage changes overnight or mid-month, AI detects updated payer responses and alerts your team, preventing denials caused by outdated eligibility data.
Verified eligibility data populates into patient charts, claims, and billing workflows for clean submission and faster reimbursement with zero manual entry required.
HealOS delivers accuracy, speed, and automation that improve financial performance, reduce administrative burden, and enhance patient experience across every stage of the revenue cycle.
AI eliminates manual data entry errors and retrieves exact payer details, significantly reducing eligibility-related denials and improving clean-claim acceptance rates.
Real-time verification accelerates front-desk workflows, reduces wait times, and gives staff instant access to accurate benefit information at the point of service.
By validating coverage upfront, HealOS prevents 25% of claim denials caused by eligibility issues, reducing rework, appeals, and lost revenue.
Automated verification reduces labor requirements by up to 75%, allowing teams to focus on patient care, financial follow-up, and more strategic functions.
Providing upfront cost estimates and real-time coverage information reduces confusion, avoids billing surprises, and strengthens patient trust.
HealOS continuously verifies eligibility and coverage across commercial, Medicare, and Medicaid plans, reducing denials and ensuring every encounter is billed with accurate, up-to-date insurance data.
Our voice-enabled AI calls insurers directly when portal data is missing or unavailable. This delivers 99% accurate benefit verification even for complex plans, improving financial certainty and workflow reliability.
HealOS integrates with major EHRs and payer portals Epic, Athena, Cerner, Availity, Waystar, and 1,300+ insurers, allowing teams to automate eligibility checks without changing existing workflows.
By identifying inactive plans, benefit changes, deductible resets, and authorization requirements upfront, HealOS prevents 20–40% of eligibility-related denials and accelerates clean claim submission.
HealOS processes hundreds of eligibility checks per minute, reduces labor costs by up to 75%, and maintains strict HIPAA-compliant security, making it ideal for both small practices and large multi-location networks.
"HealOS transformed our eligibility verification process. We went from spending hours on phone calls to getting instant coverage confirmation. Denials dropped by 22%, and our front desk staff can now focus on patient care instead of insurance verification."
"The continuous monitoring feature is a game-changer. HealOS caught coverage changes that would have led to denials, saving us thousands in lost revenue. The ROI was clear within the first month."
"Voice-enabled verification means we never miss coverage details, even when payer portals are down. Our clean claim rate improved significantly, and patient check-in is now faster and smoother."
Everything you need to know about automated insurance eligibility verification
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