Automate Insurance Verification
Stop chasing denials. Start collecting payments.
Confirm patient coverage instantly with AI-driven eligibility verification
Automated eligibility checks to reduce claim denials.
Phreesia is the only E&B platform that combines real-time eligibility, AI-driven copay selection and proactive patient workflows—so staff spend less time in payer portals and more time with patients.
Automate eligibility checks and seamlessly collect copays
Save staff time and reduce denied claims with automated and on-demand checks. We offer:
- Unlimited, real-time checks with immediate visibility into copay, deductible and out-of-pocket amounts
- Out-of-network and expired coverage alerts prevent uncompensated care and surprise bills
- Payer and eligibility alerts, including Primary Payer, MCOs and Medicare annual wellness visit
Phreesia performs an average of 3 E&B checks before a patient checks in
33% of patients are flagged with incomplete eligibility, helping staff prevent claim errors
1,000+ payers, including Medicare and Medicaid
Collect up-to-date coverage before the visit
Accurate patient insurance and contact details means fewer denied claims and less rework. With Phreesia you can:
- Allow patients to quickly confirm previously entered insurance with a single click
- Let patients upload new insurance cards using the photo upload feature
- Send reminders before appointments to collect missing or updated insurance details in advance
Manual verifications take a minimum of 12 minutes
24% of denied claims are due to mistakes during registration and eligibility verification
Boost collection accuracy with AI-driven copay selection
Our AI-driven copay selection surfaces the correct copay during intake—factoring in specialty, visit type, payer nuances and out-of-pocket max status. With Phreesia you get:
- Smart copay tiering: Auto-populate copay amounts based on contracted payer tiers
- E&B for all specialties: Primary care, specialist, urgent care, dental and vision
- Copay suppression logic: Automatically suppress copays for specific appointment types, specialties, or when a patient’s out-of-pocket max has been met.
Save 3-5 minutes per patient with out-of-network tags
Prevent claim denials and save $50+ per out-of-network patient identified
When paying is easy, patients do it
When patients complete digital intake, they’re asked for the right copay and balance up front—so you collect sooner and reduce back-end work. We make payments simple with options like:
- Apple Pay® and Google Pay™
- Self-service payment plans
- Card on file with autopay
- Digital statements
- Credit, debit and FSA/HSA transactions
- Online payments
With Phreesia, more than 80% of patients pay copays at the time of their visit
Boost post-time of service collections by 73% in 6 months, on average
96% of patients are satisfied with their Phreesia experience
Apple Pay® is a registered trademark of Apple Inc.
Fewer surprises. Smoother visits.
Give patients visibility into their deductible and out-of-pocket balances before they arrive, so they’re prepared to pay and less likely to delay care. Automated pre-visit summaries reduce confusion, cut call volume and help patients get the most from their benefits.
With Appointment Readiness, you can:
- Share patient-specific benefits in advance of the visit
- Proactively flag deductible and out-of-pocket balances
- Reduce patient billing questions and inbound calls
- Help patients understand and use their coverage effectively
What sets Phreesia apart?
- AI-driven copay selection: Removes guesswork, so patients see and pay the right amount up front
- Smart copay suppression: Suppresses copays when patients have met their out-of-pocket max or when it doesn’t apply to a specific group of patients
- Out-of-network alerting: Flag issues early to prevent claim denials and patient escalations
- Appointment Readiness: Proactively educate patients on their benefits, reducing surprises and delayed care
Ready to reduce denials and get paid faster?
Put AI-enabled eligibility verification to work for your organization.
Short-staffed? We can help.
Staff shortages are not new to healthcare, and many organizations have been dealing with them for years. Luckily, Phreesia is like adding more staff members to your team.
Success stories
No matter your size, location or patient demographic, Phreesia can help your organization drive outcomes that matter.
