How It Works
For every upcoming session we check what insurance will cover and what the patient owes, then write it into the chart your team already uses.
What we check on every appointment
Eight checks, in the same order, every time. Pick one to see where it lands in the chart.
Who actually pays, including carve-outs to Optum, Evernorth, Carelon and Magellan.
Miss it and you bill the wrong company.
Active coverage on the date of service, not just today.
Miss it and a plan that ended last month turns into a denial.
In-network status for the clinician seeing the patient.
Miss it and the patient gets reduced or no benefits.
Copay or coinsurance for the service being billed.
Miss it and the patient pays the wrong amount, then gets a bill.
How much is met and what the patient owes at check-in.
Miss it and the patient gets a surprise bill for the full session.
Whether it is required, and when an existing one runs out.
Miss it and the session may not be paid at all.
The annual cap and how many sessions have been used.
Miss it and sessions past the cap get denied.
Coverage and place of service for virtual sessions.
Miss it and virtual sessions get denied.
- 9:00 AMOlivia Grant90837✓ Verified
- 10:00 AMDaniel Kim90834✓ Verified
- 11:00 AMSofia Alvarez90837Policy inactive
- 1:00 PMMarcus Bell90837✓ Verified
- 3:00 PMEmily Ross90834Out of network
- 4:00 PMNora Whitfield90847✓ Verified
James Carter
| Clinician | Dr. Patel |
|---|---|
| Frequency | Weekly, 90834 |
| Insurance | Cigna, through Evernorth |
| Due at check-in | $28.40, 20% coinsurance |
| Balance | $0.00 |
Upcoming sessions
- Mon 3/16, 2:00 PM✓ Verified
- Mon 3/23, 2:00 PM✓ Verified
- Mon 3/30, 2:00 PMScheduled
VeriframeThu 9:15 AM
03/12/2026 | CIGNA / EVERNORTH | Plan Type: LocalPlus IN | ACTIVE eff 01/01/2024 | INN | CPT: 90834 | Copay: $0.00 | Co-ins: 20% | Ded: $2,000.00 met out of $2,000.00 | OOP: $1,842.10 met out of $5,000.00 (as of 03/12/26) | Telehealth: Covered, POS 10 | Visit limit: 30 per year, 11 used | PA: Not required | COB: None | Confirmed by Veriframe MT via Evernorth | Ref: EV-88213
Front deskThu 9:40 AM
Let James know to expect about $28 at check-in.
Dr. PatelMon 3/9
Progress note signed.
| BH administrator | Evernorth Behavioral Health |
|---|---|
| Coverage | Active on 3/16 |
| Network | In-network for Dr. Patel |
| Cost share | 20% coinsurance |
| Deductible | Met, $2,000 of $2,000 |
| Prior authorization | Not required for 90834 |
| Visit limit | 30 per year, 11 used |
| Telehealth | Covered, POS 10 |
Confirmed on the Evernorth portal, ref #EV-88213. Second review complete.
- Benefits verification, 3/16Veriframe · Thu 3/12
- Insurance card, front and backUploaded · 1/08
- Intake packetSigned · 1/08
- Consent to treatSigned · 1/08
- Release of informationSigned · 1/08
- Treatment planSigned · 2/02
| Date | Client | Code | Patient owes | Coverage |
|---|---|---|---|---|
| 3/16 | James Carter | 90834 | $28.40 | ✓ Verified |
| 3/13 | Olivia Grant | 90837 | $25.00 | ✓ Verified |
| 3/12 | Marcus Bell | 90837 | $0.00 | ✓ Verified |
| 3/09 | James Carter | 90834 | $28.40 | ✓ Verified |
| 3/09 | Daniel Kim | 90834 | $40.00 | ✓ Verified |
| 3/06 | Nora Whitfield | 90847 | $20.00 | ✓ Verified |
| 3/05 | Olivia Grant | 90837 | $25.00 | ✓ Verified |
| 3/05 | Marcus Bell | 90837 | $0.00 | ✓ Verified |
Illustrative record. Names, plan details and figures are examples.
01
Connect once
A secure link to your EHR, under a signed BAA.
02
We verify ahead
Every appointment, before the visit.
03
It lands in the chart
One format. Urgent items flagged.
What we flag, and when
Urgent issues reach your front desk before the visit. The rest waits in the chart for check-in.
Flagged before the visit
- Policy inactive
- Prior authorization required
- Service not covered
Noted for check-in
- Deductible not met
- Out of network
- Missing patient information
See it on your own schedule
We can verify a week of real appointments alongside your team, so you can compare the results directly.
Book a call