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Primary Care Practice · Primary Care

Primary Care Eligibility Verification Automation

Illustrative Revenue Cycle Automation Scenario. This scenario demonstrates how a healthcare organization could apply revenue-cycle automation. It is not presented as an actual customer result.

The Challenge

A primary care practice with high patient volume was losing revenue to eligibility-related denials. Front desk staff checked coverage once at patient intake, but coverage changes during the year were not caught. High-deductible plan patients arrived without understanding their financial responsibility, leading to uncollected co-pays and delayed payments.

The Approach

Sarva automated eligibility verification at appointment booking and again on the morning of the visit.

Benefits details — co-pay, deductible, coinsurance — were extracted and presented to front desk staff.

High-deductible patients were flagged for pre-visit financial counseling.

Coverage terminations triggered immediate alerts so appointments could be rescheduled or self-pay options discussed.

Illustrative Outcomes

Eligibility-related denials

Illustrative elimination of avoidable eligibility denials

Pre-visit collection rate

Illustrative improvement from 45% to above 80%

Staff time on eligibility

Illustrative 90% reduction

Outcomes are illustrative and do not represent actual customer results.

Key Lessons

Dual eligibility checks (at booking and day-of) catch coverage changes that single checks miss.
Benefits detail extraction enables accurate patient cost estimates and improves upfront collections.
Automated high-deductible flagging improves financial counseling workflow.

See how this approach could work for your organization.

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