Medicaid Eligibility Verification Software

Built for Medicaid’s Complexities in Behavioral Health

Access real-time eligibility from state Medicaid files, see behavioral health carve-outs other platforms miss, and catch terminated coverage before it costs you thousands.

How your team benefits

Verify Real-Time Medicaid Status

Verify coverage directly on leads, contacts, accounts, and custom objects while the caller is on the line.

Behavioral Health Benefits That Matter

Results write back with owner, tags, notes, and time verified so admissions and billing stay aligned.

Verify Anywhere, Anytime

Use native CRM reports to track active versus inactive coverage, payer mix, and time to first action.

Find Coverage With Incomplete Data

Use our API to connect VerifyTX to other CRMs so your process stays in one place.

"What used to take us over an hour now takes minutes. The intake team doesn’t need to rely on us anymore just to verify benefits."

— JoElle Vincent, Business Office Director at Low Country Behavioral Health

increase in verified inquiries admitted

Beyond Verification: Revenue Protection for Medicaid

Stop reacting to denials. Start preventing them. Our platform delivers the eligibility details, lapse detection, and seamless handoffs needed to protect revenue from the very first intake call.

Real-Time Eligibility with Deep Payer Logic

See co-pays, deductibles, and behavioral health carve-outs in real time. Go beyond "active" status to make confident financial decisions. Know patient responsibility upfront—before admission, not after discharge.

Insurance Discovery & Policy Lookup

Locate active Medicaid coverage even with incomplete patient data. Reduce verification dead-ends and uncover billable policies. A unique capability most Medicaid verification tools lack.

Automated Census Monitoring & Lapse Detection

Automatically flag inactive Medicaid policies across your entire census. Catch the root cause of 85% of eligibility denials before claims go out. Most facilities find at least one lapsed policy per week—that's $7-10K saved every time.

Seamless Salesforce & CRM Integration

Run Medicaid verifications and attach results directly to contact records. Eliminate duplicate entry and ensure perfect admissions-to-billing handoffs. Keep your workflow in one system.

Proactive Payer Alerts & Financial Responsibility

Automated alerts for benefit changes, authorization requirements, and Medicaid carve-outs, logged as internal payer notes so admissions has clarity before intake. Provide clear patient financial responsibility upfront.

Multi-State & Multi-Payer Management

Manage Medicaid eligibility across all 50 states in one login. Our platform handles state-specific rules and system nuances, so expanding services or opening new locations doesn't break your verification workflow.

What your team sees

Trusted by Healthcare Professionals

We verify our census at least once a week, and catch a minimum of one termed policy each time with VerifyTX. That translates to several thousands of dollars a week saved.

VerifyTX delivers near-immediate benefit verification at your agents’ fingertips.
Simple to install and configure, easy to extend with Salesforce, and backed by a responsive, collaborative team. We tried multiple solutions before switching and are glad we did. Painless, effective, and affordable.

BRAD OVERLUND

Director of Operations, Healthcare Services

Frequently Asked Questions

You’ll see the full financial picture needed for behavioral health: coverage dates, member IDs, co-pays, deductibles, and—critically—detailed benefits for SUD and mental health treatment levels (e.g., inpatient residential, intensive outpatient). We show you the carve-outs and authorizations so you know exactly what is covered before admitting.

Up to 85% of denials stem from eligibility issues like inactive policies or missed coverage changes. Our platform provides real-time, accurate data and includes automated lapse detection that actively monitors your census for terminated coverage. This allows you to address problems before services are rendered and claims are submitted.

Yes. Unlike calling state Medicaid offices, our real-time system is available 24/7/365. This is essential for admissions teams handling intake calls during evenings, weekends, and holidays, ensuring you never miss an opportunity to help someone ready for treatment.

It works natively inside your CRM. Install the VerifyTX component, and your team can run a verification from any lead, contact, or account record with one click. All results—coverage details, notes, and the verification timestamp—are written back to the record. This eliminates duplicate data entry and creates a perfect handoffs.

Our insurance discovery feature locates active Medicaid and commercial policies even with incomplete data. This drastically reduces "no insurance found" dead-ends and helps you locate billable coverage that manual verification misses.

All 50 states. Our platform accesses 1,700+ payers, including state Medicaid programs, Medicaid managed care plans, and commercial insurers. We handle state-specific rules and system differences automatically.

Most clients are up and running in days, not months. Because our platform is cloud-based, not a legacy enterprise system, implementation is fast. Our team handles setup and provides dedicated support to ensure your team is successful.