Automating Patient Eligibility Verification for Healthcare Providers
Streamlining patient eligibility checks with Zeurons AI: faster processing, fewer denials, and improved patient experience.
Challenge:
Many healthcare providers struggle with manual, time-consuming insurance eligibility checks for upcoming appointments, leading to billing errors and delays in patient access to care.
Solution:
Zeurons AI deployed an intelligent automation bot that scans future appointments in the EMR and verifies eligibility across top insurance portals (Availity, BCBS, Athena, Humana, Cigna, United Healthcare). The bot captures eligibility screenshots and updates notes directly in the patient record.
Benefits:
Faster verification: Significantly reduces staff workload and speeds up patient processing at check-in.
Fewer denied claims: Automated pre-checks catch ineligible coverage before appointments, minimizing billing rework.
Greater accuracy: Every eligibility check is documented with screenshots and notes, ensuring audit-readiness.
Improved patient experience: Patients are notified early about coverage issues, reducing wait times and surprise bills.
Regulatory compliance: Automated records support payer audits and meet documentation requirements.
Results:
Providers using Zeurons AI have reported up to 60% faster eligibility verification, 30% fewer claim denials, and higher patient satisfaction at check-in.