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Closing the Loop

Most eligibility tools flag the problem. Phreesia fixes it.

Front-end errors cause nearly 1 in 4 denied claims. Phreesia doesn’t just identify coverage issues—it automatically selects the correct insurance plan and writes it back to your PM or EHR without anyone touching it. Unlimited real-time checks. Zero manual verification. Claims go out clean the first time.

Verify coverage without lifting a finger. Clean data in means clean claims out. The task doesn’t get flagged—it gets eliminated. Phreesia uses AI to select the right copay. Patients know what they owe before they walk in.

Phreesia runs unlimited, real-time eligibility checks automatically—at scheduling, before the visit and again as the appointment nears—across 1,000+ payers including Medicare and Medicaid. No portals, no per-check pricing, no manual calls. Coverage is confirmed the moment it changes, so staff stop chasing verifications and start every claim on solid ground.

Phreesia captures accurate demographics, insurance and consent before the patient arrives—so errors never reach the claim. It flags out-of-network and coverage issues in time to act, not after the claim comes back. Clean data at intake means clean claims downstream.

The correct insurance plan is selected and written back to your PM or EHR automatically—no staff action required. The write-back happens inside the systems your team already uses, not on top of them.

It also suppress the ones that shouldn’t be charged, so every amount is correct before the patient pays. Practices see a 73% average increase in time-of-service collections within six months, with text-to-pay, mobile pay, Apple Pay®, Google Pay, card on file and payment plans, all connected to what eligibility already confirmed.

Once eligibility is confirmed, Phreesia turns it into a plain-language benefits summary—deductible, out-of-pocket balance and expected responsibility—delivered before the visit. Patients arrive prepared to pay and ready with fewer questions, so the front desk fields fewer coverage calls and time-of-service collections climb.

Verify coverage without lifting a finger.

Phreesia runs unlimited, real-time eligibility checks automatically—at scheduling, before the visit and again as the appointment nears—across 1,000+ payers including Medicare and Medicaid. No portals, no per-check pricing, no manual calls. Coverage is confirmed the moment it changes, so staff stop chasing verifications and start every claim on solid ground.

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automated eligibility checks for every visit

Clean data in means clean claims out.

Phreesia captures accurate demographics, insurance and consent before the patient arrives—so errors never reach the claim. It flags out-of-network and coverage issues in time to act, not after the claim comes back. Clean data at intake means clean claims downstream.

The task doesn’t get flagged—it gets eliminated.

The correct insurance plan is selected and written back to your PM or EHR automatically—no staff action required. The write-back happens inside the systems your team already uses, not on top of them.

Phreesia uses AI to select the right copay.

It also suppress the ones that shouldn’t be charged, so every amount is correct before the patient pays. Practices see a 73% average increase in time-of-service collections within six months, with text-to-pay, mobile pay, Apple Pay®, Google Pay, card on file and payment plans, all connected to what eligibility already confirmed.

Patients know what they owe before they walk in.

Once eligibility is confirmed, Phreesia turns it into a plain-language benefits summary—deductible, out-of-pocket balance and expected responsibility—delivered before the visit. Patients arrive prepared to pay and ready with fewer questions, so the front desk fields fewer coverage calls and time-of-service collections climb.

What clients say

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Frequently asked questions

Eligibility verification is the process of confirming a patient’s insurance coverage, benefits and financial responsibility before care is delivered. For high-performing organizations, it’s not administrative overhead—it’s a revenue driver. When eligibility is handled early and accurately by health insurance verification software, claims go out clean, patients know what they owe and collections happen before the visit ends. An estimated 24% of denied claims trace back to front-end eligibility errors. Phreesia prevents them.

Real-time insurance eligibility verification means coverage is confirmed instantly—no manual calls, no delays, no guesswork. Phreesia runs checks automatically at scheduling, before the visit and again closer to the appointment. Coverage issues are caught before check-in. Patients aren’t surprised at the front desk.

Automated pre-visit verification. Unlimited checks—not per-check pricing that creates gaps. Real-time write-back to the PM or EHR. Broad payer connectivity including Medicare and Medicaid. And deep integration with scheduling, registration and payments so eligibility doesn’t live in a silo. Phreesia does all of this—on one platform, across 16+ EHR integrations.

When you know exactly what a patient owes before the visit, you can collect it before they leave. Phreesia connects eligibility directly to payment workflows: patient responsibility is calculated automatically, patients are prompted to pay at check-in and more than 80% pay copays at the time of their visit.

Stop flagging problems. Start eliminating them.

See how Phreesia closes the loop—from eligibility to payment—before the patient leaves the building.