Confirming active coverage, copay, deductible and referral requirements before the patient arrives.
Checking coverage one patient at a time by phone or portal is the most expensive way to get an answer that is available in bulk. Skipping it is worse: the visit happens, the claim is denied, and the balance becomes a patient-collections problem instead.
What goes wrong today
Checking coverage one patient at a time by phone or portal is the most expensive way to get an answer that is available in bulk. Skipping it is worse: the visit happens, the claim is denied, and the balance becomes a patient-collections problem instead.
What good looks like
Coverage checked ahead of the visit, with copay and deductible known at check-in and referral or PCP requirements surfaced before they become a denial.
Batch checks ahead of the schedule, not one at a time
Copay and deductible known before arrival
Referral and PCP requirements flagged early
Self-pay path when coverage is inactive
What to measure
Pick these before you change anything, so the effect is visible rather than anecdotal.
Share of visits verified pre-service
Denials for eligibility reasons
Point-of-service collection rate
Where we stand: In development
In development. A clearinghouse covers this well today and is the honest recommendation in the meantime.
Rollout checklist
Document how this is handled today, and by whom.
Put a number on the hours or dollars involved.
Decide which cases must always reach a person.
Agree the metrics you will judge success on.
Frequently asked questions
Do you solve this today?
In development. A clearinghouse covers this well today and is the honest recommendation in the meantime.
How do we work out whether this is our biggest gap?
The Front Desk Opportunity Scan estimates the hours and revenue behind each area from your own volumes and ranks them against each other.
Keep going on MedReception.ai
MedFrontDesk.ai is the playbook library. MedReception.ai is the platform that runs it.