Your billing team shouldn't spend hours fixing preventable denials. VerifyTX gives admissions the tools to verify benefits correctly the first time so claims go out clean and get paid faster.
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Your billing team is downstream from admissions. When intake gets it wrong, you're the one who has to fix it, and by then the damage is already done.
You get the encounter a week later and start working the claim. That's when you discover the plan has a $5,000 unmet deductible, or your facility is out of network under this specific product, or the plan carved out behavioral health to Beacon. Admissions called the number on the card and got a generic benefits confirmation. Nobody caught the carve-out or the fact that this particular plan excludes residential. Now you're stuck trying to collect from a client who thought insurance was covering everything, or you're writing off $18,000 because the family can't pay. Your CFO wants to know why write-offs are up this quarter. You already know why.
The client has been in your IOP for three weeks. You submit the claim and it comes back denied because prior auth was required and nobody requested it. Now you're chasing a retro-auth while the client is already discharged, the documentation is incomplete, and the payer is saying they won't authorize services after the fact. You either write it off or spend 6 hours on a peer-to-peer appeal for a $3,200 claim. Your biller could have processed 15 clean claims in that time. Instead they're on hold with Optum trying to fix something that should have been caught on day one.
The authorization expires in 5 days and nobody told you. The client's plan renewed with a new deductible and census didn't flag it. Admissions updated the insurance card in the EMR but didn't re-verify eligibility. You find out when the claim denies for "coverage terminated" and you're 60 days past DOS. Now you're calling the client asking them to provide proof of coverage for dates of service that already happened. Your A/R over 90 days is climbing and your revenue cycle consultant keeps asking why your denial rate is 18% when the industry average for behavioral health is 12%. You know exactly why. The front end isn't doing its job.
VerifyTX pulls benefits directly from payer systems and cross-references your facility data. It flags out-of-network status, carve-outs, deductibles, and exclusions a phone rep wouldn't mention. Admissions sees the alert before they book the assessment.
The system flags prior auth requirements before the first date of service. Admissions requests the auth upfront. Your claims go out with valid auth numbers and process on the first pass.
VerifyTX helps you flag the billing quirks that cause denials. Medical necessity requirements, specific exclusions, credentialing issues, Carelon or CredibleMind carve-outs. Admissions sees these at verification and sets proper financial expectations or declines the admission. You stop working claims you should have never accepted.
The system tracks every client's authorization period and plan renewal date. Admissions gets flagged when a client is 30 days out from re-verification. They pull new benefits and update the auth before the next claim batch. You're not finding out about terminated coverage after you've already billed two weeks of PHP.
Your billing manager can see exactly what admissions verified, when they verified it, and what alerts were flagged. You know which clients are high-risk before you ever work the claim.
Most billing software helps you work claims faster but doesn't fix bad intake data. VerifyTX puts verification tools in admissions' hands so they catch eligibility issues before the client admits. You're preventing the problem instead of cleaning it up after the fact.
Billing-focused tools are too complicated for intake staff. VerifyTX was built for admissions. It's simple, works on mobile, and gives them answers in plain language. When the tool is easy to use, your intake team verifies correctly. When they verify correctly, your claims go out clean.
VerifyTX was built for SUD and mental health providers. It understands H codes, 1002 modifiers, and the fact that your IOP bills differently than your residential. Generic eligibility tools don't understand behavioral health billing. VerifyTX does.
If you're bringing RCM in-house or replacing a vendor, VerifyTX gives your team the same front-end verification capabilities the big billing companies have. Your admissions staff can verify as accurately as a vendor's intake team, and your billing department gets clean data from day one.
Admissions verified benefits and told the family insurance would cover treatment. The client completes 28 days. You bill the claim and discover a $6,000 unmet deductible. The family can't pay and you write off $32,000. After implementing VerifyTX, admissions sees deductible amounts at verification and sets accurate financial expectations before the client admits. Write-offs drop by 60% in six months.
Your billing team spent 15 hours a week chasing retro-auths for clients whose initial auth expired mid-treatment. VerifyTX flags clients approaching their auth limit 30 days out. Admissions requests continuation auth before the current period ends. Your auth-related denials dropped from 12% of total denials to under 2% in three months.
You outsourced RCM for five years but the vendor's denial rate was stuck at 16%. You brought billing in-house and implemented VerifyTX for admissions. Within 90 days your denial rate dropped to 9%. Your days in A/R went from 52 to 38. You're collecting $140,000 more per month than under the vendor, and your in-house team costs less.
“Our denial rate for eligibility issues dropped from 14% to 4% in the first quarter. My billing team went from spending half their time fixing intake mistakes to actually working denials we can appeal.”
“We brought billing in-house and needed admissions to verify correctly without constant supervision. VerifyTX gave them the tools to do it right. Our write-offs are down 58% year over year.”
VerifyTX has an API that allows most major EMR and billing platforms to integrate with our system. If you want eligibility data to flow directly into your existing software, we can work with your platform or IT team to set up the connection. Many facilities use VerifyTX standalone alongside their EMR, and others integrate through our API depending on their workflow needs.
Your billing software runs eligibility checks in batches, not in real time on the phone. VerifyTX was built for admissions staff. It's faster, works on mobile, and surfaces payer alerts your billing system doesn't catch. Admissions uses VerifyTX at inquiry. Billing uses your practice management system for claims. Both tools work together for cleaner data and fewer denials.
That's the point. If the client's plan won't cover your services, you need to know before they admit, not after the claim denies. VerifyTX lets admissions make informed decisions. If coverage is insufficient, they can work out private pay, refer to an in-network provider, or help find alternative coverage. You're not admitting clients you can't collect from.
VerifyTX pricing is based on your facility size and verification volume. Most facilities see ROI within 90 days through improved collections and reduced denials. Compare that to outsourced RCM vendors who typically charge 4% to 8% of collections. If you're collecting $200,000 per month, you're paying the vendor $8,000 to $16,000 monthly. VerifyTX gives your in-house team better front-end verification tools at a fraction of that cost, and you keep the margin you were paying the vendor.
Yes. During the demo we can review your denial reports and identify patterns. Most facilities lose revenue to preventable eligibility denials, authorization gaps, and out-of-network surprises. We'll show you how VerifyTX would have prevented specific denials in your recent claim history.
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Read the full article →See how VerifyTX prevents denials before claims ever go out. We'll walk you through a real demo with your actual payer mix and show you exactly which denials you could have avoided.
