Electronic when possible. Human review when necessary.
Accurate Insurance Verification Services for Healthcare Providers
Is your patient’s coverage ready before the visit? Dastify Solutions verifies insurance coverage before the date of service. Our experts identify potential issues early and help address them before they disrupt the patient visit.
HIPAA-Compliant WorkflowsSecure Data HandlingPayer NetworkEligibility Specialists
Common Insurance Verification Challenges
An insurance card doesn't tell your team everything it needs to know.
Before the visit, you may need to confirm:
Coverage is active
Benefits and patient responsibility
Primary payer and network status
Authorization or referral requirements
When information is incomplete or identified late, it can lead to delays, additional staff follow-up, claim rework, and unexpected patient balances.
Know the Patient’s Coverage Before the Visit.
Dastify Solutions help your team identify these issues before the visit.
Comprehensive Eligibility & Benefits Verification Services
Dastify Solutions provides insurance verification services designed around the information your team needs before the patient visit.
Insurance Eligibility Verification
Verify available coverage information, including:
Active or inactive status
Effective and termination dates
Plan type
Member and subscriber information
Insurance Benefits Verification
Review available benefit information relevant to the planned service:
Deductibles
Copays
Coinsurance
Out-of-pocket information
Service-specific benefits
Payer & Coordination of Benefits Verification
Review available information related to multiple insurance plans:
Primary, secondary and tertiary coverage
Coordination of benefits
Medicare crossover information
Payer-order discrepancies
Patient Responsibility Verification
Provide available cost-sharing information to support patient-access workflows:
Deductible status
Copay requirements
Coinsurance
Out-of-pocket information
In-network and out-of-network benefits
Patient responsibility information is based on available payer data and remains subject to final claim adjudication and applicable plan terms.
Authorization & Referral Verification
Identify requirements that could affect whether a service can proceed.
Prior authorization requirements
Referral requirements
Service-specific requirements
Required information or documentation
Existing authorization information
Authorization reference numbers
Pre-Visit & Batch Verification
Verify coverage before appointments:
Upcoming appointment verification
Batch patient-list processing
Coverage-change identification
Exception flagging
Re-verification closer to the date of service
Payer Follow-Up & Exception Resolution
When electronic verification doesn't provide the full answer, our specialists can investigate.
Payer portals
Telephone verification
Incomplete response follow-up
Conflicting payer information
Missing coverage details
Our Eligibility Verification Process
01. Verify Eligibility
Coverage and available benefit information is reviewed through electronic eligibility transactions and appropriate payer resources.
02. Review Benefits
We review available benefits, network information, payer order, limitations and authorization requirements based on the planned service.
03. Research Exceptions
Incomplete or conflicting responses can be escalated for additional payer research.
04. Document Results
Verification findings, payer responses, reference information and unresolved items are documented through the agreed workflow.
05. Deliver Actionable Information
Your team receives the information needed to address identified issues before the patient encounter or claim submission.
AI‑Driven Eligibility Verification With Human Oversight
Dastify Solutions combines AI-driven validation, electronic eligibility transactions and specialist expertise to help your team review coverage and benefits information more efficiently.
Our technology supports the identification and organization of eligibility and benefits information, while experienced specialists review exceptions and conduct additional payer research when electronic responses are incomplete or unclear.
Depending on the payer and workflow, verification may include:
ANSI X12 270/271 transactions
Clearinghouse eligibility networks
Commercial payer portals
Medicare eligibility resources
Medicaid portals
Telephone verification
Medicare & Medicaid Eligibility Verification
Medicare Eligibility
Verify available Medicare coverage information, including applicable enrollment and plan details.
Medicare Advantage
Review available Medicare Advantage plan information, network considerations and applicable benefit or authorization requirements.
Medicaid Eligibility
Verify available Medicaid enrollment and managed-care information based on the applicable state and payer resources.
Specialty-Specific Eligibility Verification
Eligibility, benefit and authorization requirements can vary by specialty and payer. We can structure verification workflows around specialty-specific requirements for:
Eligibility Verification for Healthcare Organizations
We can support eligibility and benefits verification workflows for:
Why Choose Dastify Solutions
Comprehensive Verification
Technology & Specialist Expertise
Actionable Documentation
Flexible Verification Workflows
Reduced Administrative Burden
50+ EHR, EMR & Practice Management Expertise
Pre-Visit Coverage Visibility
HIPAA-Compliant Processes
Frequently Asked Questions
What is the difference between insurance eligibility verification and benefits verification?
Eligibility verification checks whether a patient’s insurance coverage is active for the planned date of service. Benefits verification reviews how the plan applies to the scheduled service, including patient cost-sharing and coverage limitations. Dastify Solutions reviews both so your team has more useful information than an active-coverage status alone.
What insurance information does Dastify Solutions verify before an appointment?
We review available coverage and service-specific benefit information, including plan dates, patient cost-sharing, network status, payer order, and authorization or referral requirements. The verification scope is tailored to your specialty and scheduled services. Any missing or unclear information is flagged for follow-up.
When should insurance eligibility be checked, and do returning patients need re-verification?
Check coverage before the appointment with enough time to investigate issues. Returning patients also need re-verification because coverage and benefit details can change. Dastify Solutions can structure checks around your appointment schedule with rechecks closer to the date of service and when insurance information changes.
How long does insurance eligibility and benefits verification take?
Electronic checks may return quickly, but a complete benefits review can take longer when payer information is missing or telephone follow-up is needed. Dastify Solutions establishes turnaround expectations around your appointment volume and verification requirements. Cases awaiting payer clarification are flagged rather than treated as complete.
Can Dastify Solutions verify Medicare, Medicare Advantage, and Medicaid coverage?
Yes. We review available enrollment and benefit information through the appropriate payer resources. Medicare Advantage requires checking the specific plan, while Medicaid verification depends on the state program and any managed-care enrollment. Our Medicare Part B billing guide for small practices explains related eligibility and billing considerations.
How much do outsourced eligibility verification services cost?
Pricing depends on patient volume, the depth of benefits review, and the amount of payer follow-up required. Dastify Solutions reviews your workflow before defining the service scope and providing a quote. The proposal should clarify whether batch checks, re-verification, and exception research are included.
Can eligibility and benefits verification help reduce claim denials?
It can help reduce preventable eligibility-related denials by identifying inactive coverage, incorrect policy information, and missing authorization requirements before billing. Your team still needs to address the findings, and verification cannot prevent every denial. Our guide to medical claim denial causes and prevention explains how front-end checks fit into a broader prevention process.
Get Reliable Insurance Eligibility Verification Services for Your Practice
Dastify Solutions can review your current eligibility verification process and define a workflow around your appointment volume, requirements and exception needs.