🟢 Trusted by Healthcare Teams • 40+ Payers • HIPAA Secure
Insurance Verification & Eligibility Services
Stop Revenue Loss before It Starts
Accurate insurance verification before every appointment to help reduce denials, speed up payments, and maximize collections. Around 27% of claim denials occur because insurance eligibility was not properly verified before the patient’s visit. Since each denied claim can cost $25 to $181 to correct and resubmit, eligibility verification is one of the most expensive yet most preventable issues in the revenue cycle. Every unverified patient increases financial risk, while timely insurance verification reduces denials and protects your revenue.
- Verified 72 hours before every scheduled appointment
- EDI 270/271 + payer portal real-time verification
- Works inside your existing EHR no system changes
- HIPAA-focused · BAA provided at onboarding
WHAT WE DO
Every Insurance Check We Handle for Your Practice
A complete insurance verification workflow managed by your dedicated team, documented in your EHR, before every patient arrives.
Pre-Visit Eligibility Verification
Systematic verification of every scheduled patient’s insurance coverage 72 hours before their appointment active status, plan details, and all key benefit components confirmed and documented.
Real-Time Benefits Verification
Live benefits checks via EDI 270/271 transactions and payer web portals returning copay, deductible, coinsurance, and out-of-pocket data for accurate patient estimates and upfront collections.
Coverage & Deductible Confirmation
Deductible amount, amount met year-to-date, coinsurance percentage, and out-of-pocket maximum all confirmed and entered into the patient record prior to every visit.
Coordination of Benefits (COB) Checks
When patients carry primary and secondary insurance, coordination of benefits is verified primary vs. secondary payer order confirmed, preventing claim crossover errors and delayed reimbursement.
Secondary Insurance Verification
Secondary and tertiary payer coverage verified separately benefit limits, coverage order, and billing requirements documented before any service is rendered to prevent split-billing errors.
Eligibility Reverification on Denial
When a claim is denied with an eligibility-related code, we reverify current coverage, identify what changed, update the patient record, and prepare corrected claim resubmission documentation.
MAJOR PAYERS WE SUBMIT TO
HOW IT WORKS
Your Verification Workflow From Roster to Appointment
1
Appointment Review
Patient appointments are pulled from your EHR or practice management system, and each scheduled patient is queued for verification up to 72 hours before the visit.
2
Insurance Verification
3
EHR Documentation
4
Re-verification (When Needed)
High-risk cases, such as recent insurance changes or Medicare/Medicaid plans, are re-verified before the appointment.
5
Denial Resolution
If an eligibility-related denial occurs, we identify the root cause, update the verification details, and support claim correction and resubmission.
INDUSTRY INSIGHT
80%
of appealed denials can be overturned with proper documentation and timely submission.
Source: Becker’s ASC Review industry benchmark.
WHY SVIZZERA
Why Practices Trust our Insurance Verification Services
Not a check-the-box process. A systematic verification workflow that treats eligibility as a revenue protection function.
⏰
72-Hour Pre-Verification
Every scheduled patient is verified before their appointment to reduce eligibility-related denials.
📡
Real-Time Verification
Insurance eligibility is confirmed through EDI 270/271 transactions and payer portals.
🌐
Broad Payer Coverage
Support for Medicare, Medicaid, commercial plans, and regional payers across the U.S.
🔒
HIPAA-Compliant
Secure verification processes with a Business Associate Agreement (BAA) in place before accessing PHI.
👤
Dedicated Verification Team
A consistent team works with your practice to ensure accuracy and continuity.
📊
Denial Insights & Reporting
Monthly reports identify eligibility denial trends and opportunities to improve revenue performance.
FAQ
Frequently Asked Questions
Answers to the most common questions healthcare organizations ask before partnering with Svizzera.
What information is included in your insurance verification service?
We verify active insurance coverage and confirm eligibility for scheduled services. Our team also verifies plan benefits, including copays, deductibles, coinsurance, out-of-pocket maximums, coverage limitations, and any prior authorization requirements when applicable.
Can Svizzera work with our EHR, EMR, or Practice Management System?
Yes. Our team works within your existing workflow and can securely access or document verification details in your EHR, EMR, or Practice Management System, depending on your practice’s processes and access requirements.
Do you support multiple medical specialties?
Yes. We provide insurance verification services for a wide range of specialties, including primary care, cardiology, orthopedics, gastroenterology, dermatology, neurology, behavioral health, oncology, radiology, surgery, and more.
Which insurance payers do you verify?
We verify eligibility and benefits with Medicare, Medicaid, Medicare Advantage, commercial insurance plans, and regional payers across the United States using payer portals, clearinghouses, and other approved verification methods.
Can you handle high patient volumes?
Yes. Our dedicated verification team can efficiently manage daily verification requests for practices of all sizes, helping ensure patients are verified before their appointments.
What benefit information do you verify?
We verify plan-specific benefits, including deductible status, copays, coinsurance, out-of-pocket maximums, coverage limitations, referral requirements, and prior authorization requirements when applicable.
Can you verify primary and secondary insurance coverage?
Yes. We verify primary, secondary, and tertiary insurance coverage, confirm the correct coordination of benefits (COB), and document the appropriate billing order to help prevent claim denials.
What information is required to complete an insurance verification?
We typically require the patient’s name, date of birth, insurance information, subscriber ID, date of service, provider NPI, and the scheduled service or procedure, when available.
How do you help reduce eligibility-related claim denials?
By verifying insurance coverage before the patient’s visit, identifying coverage issues early, and documenting accurate benefit information, we help practices reduce eligibility-related denials, improve collections, and streamline the revenue cycle.
How quickly can Svizzera begin providing insurance verification services?
After onboarding and secure access are completed, our team can begin supporting your practice quickly with a structured implementation process designed to minimize disruption to your daily operations.
Ready To Eliminate Authorization Bottlenecks?
Let’s discuss how Svizzera can reduce administrative burden and accelerate approvals.