How it works

Every patient, one question,
answered before they arrive.

For every upcoming session, Veriframe answers the question your front desk shouldn't have to chase and writes the answer into your chart.

The one question

“If this person is seen on this date, for this service, by this provider, what will insurance pay, and what will the patient owe?”

What the patient owes

The cost conversation, right

Copay, coinsurance, deductible met and remaining. So the front desk collects the correct amount and no one gets a surprise bill.

Whether you'll get paid

The denial, prevented

Eligibility, prior auth, visit limits, in-network status, and the carve-out. A verification that nails the copay but misses a required prior auth has failed at the more important half.

How the work runs

Done before your day starts.

Your upcoming schedule is worked ahead through payer portals so results are waiting in the chart when you open.

Connecting an EHR
01

Connect once

A one-time, secure connection to your EHR under a signed BAA. Set up once, reused daily.

Verifying a session
02

We verify ahead

Every patient checked against the right payer, eligibility, copay, deductible, carve-out, prior auth, limits.

Results in the chart
03

It lands in the chart

The full benefit picture, written back in one standard format. Anything urgent, flagged. Nothing left blank.

The core skill

The card says one thing.
The benefits often live somewhere else.

This is what makes behavioral-health verification different and where denials are made or prevented.

Patient hands you
UnitedHealthcare card
→
BH benefits live at
Optum
Patient hands you
Cigna card
→
BH benefits live at
Evernorth
Patient hands you
Anthem / BCBS card
→
BH benefits live at
Carelon

Many medical plans “carve out” behavioral health to a separate administrator, Optum, Carelon, Magellan, or Evernorth. So the portal you check and the entity you'd call isn't the company on the card.

Verifying against the medical plan when benefits are carved out returns the wrong copay, misses the real auth rules, and leads straight to a denied claim. Following the carve-out correctly is the single highest-value judgment in the work and we confirm it per patient, per plan, never assume.

What you actually get

The denial that never happens. The bill that's never a surprise.

No new software, no portal to log into. A trained specialist has already read the benefits, carve-out and all and left the answer in the chart you already use. Your team just opens their day.

Patient chart · your EHR
✓ Verified by Veriframe · Jun 23
CoverageActive · in-network
PlanUnitedHealthcare (behavioral health administered by Optum)
Patient owes$30 copay · $500 left on deductible
Behavioral / telehealthCovered
Prior authNot required
Visit limitNone
Ready to seeNo action needed before the visit

That single confirmed line is the work: the carve-out caught, the prior-auth rule checked, eligibility confirmed for the date of service.

Miss any one of them and it becomes a denied claim or a surprise bill. Getting every one right, for every patient, before they walk in, that's what you're paying for. Not the note. The certainty behind it.

Exceptions, surfaced early

Nothing buried. Anything urgent, flagged before the visit.

Urgent, flagged to you promptly

Policy inactive
No coverage on the date of service. Reach the patient before the visit.
Prior auth required
Session may not be reimbursed without it, the #1 denial driver in BH.
Service not covered
Claim will be denied as billed. The practice decides how to proceed.

Standard, noted for check-in

Deductible unmet
Set patient cost expectations at check-in.
Out-of-network
Reduced or no benefits for this provider, expectations set early.
Unable to verify
Reason noted (e.g. ID mismatch); retried or escalated on corrected info.

Verification,
fully handled.

Every session verified before it happens. Carve-outs caught, claims paid, your team free. Let's get you live.

Book a walkthrough →