270/271 eligibility checks at check-in that return exact copay, deductible status, coinsurance, and active coverage — preventing the 15–22% denial rate that drives most A/R aging.
What does a 270/271 eligibility check return?
Active coverage status, plan name, group number, deductible (remaining and met), out-of-pocket max, copay by service category, coinsurance percentages, prior-auth requirements, and in/out-of-network status. The response arrives in 2–5 seconds against the patient's payer.
Why does this matter at check-in?
Roughly 1 in 6 encounters has a coverage issue — expired plan, switched payer, out-of-network referral, met deductible. Catching it at check-in lets the front desk adjust copay or collect cash-pay rates before service. Catching it post-service means a denied claim and a 90-day collection cycle on the full charge.
Which payers are supported?
All major commercial payers (BCBS, UHC, Aetna, Cigna, Humana), Medicare, Medicaid (state-by-state), and most TPAs via the Change Healthcare and Availity clearinghouse networks. Coverage runs 800+ payers across the US.
How does eligibility connect to copay collection?
The eligibility response feeds directly into copay collection — the exact copay shows on the receptionist's screen with a single-button charge against the card on file. Two API calls, one workflow.
Frequently asked questions
How fast can you get approved?
Most healthcare practices are approved within 24 hours of complete application submission. Specialty MIDs (dental DSO, behavioral health groups, DME) may take 48–72 hours while underwriting reviews trailing statements and licensure.
What does it cost?
Interchange-plus pricing — typically 2.4% + $0.10 per card transaction with no setup fee and no monthly minimum. ACH is 0.5–1.0%. You see interchange cost, assessments, and our markup on a single itemized statement.
Is the platform HIPAA-compliant?
Yes. We sign a BAA, tokenize all card and bank data before it touches your systems, and segregate PHI from payment metadata. EHR / PMS integrations move only the minimum necessary data for posting.