Insurance & verification · 4 min read · Beginner
How Amy verifies insurance in real time
Amy checks eligibility and benefits with the payer during the call, then writes the breakdown to the patient's timeline — no phone tree, no callback.
Updated Jul 7, 2026
Amy verifies insurance the moment she has a member ID and date of birth — usually while the patient is still on the phone. There is no hold music and no "we'll call you back": the eligibility request goes to the payer in real time and the answer lands on the patient's timeline in seconds.
Tip
You never have to start a verification by hand for a booked patient. Amy runs it automatically as part of booking. This article is about what happens under the hood and how to read it.
What Amy checks
When Amy runs a check she asks the payer the same questions your front desk would, just faster:
- Is the plan active on the date of service
- Deductible — individual and family, met vs. remaining
- Annual maximum — total and remaining
- Coverage percentages by category (preventive, basic, major)
- Waiting periods and frequency limits where the payer returns them
The steps, start to finish
- Amy collects the essentials on the call — carrier, member ID, subscriber name, and date of birth. If the caller is a dependent, she captures the subscriber too.
- The request goes to the payer in real time through Valian's clearinghouse connection. Most payers answer in a few seconds.
- The breakdown is written to the patient timeline and the Insurance tab, tagged with the date and the payer's response.
- Anything the payer can't answer electronically is flagged for your team as a task in What needs to get done, so nothing silently falls through.
Where the result shows up
Open the Insurance tab, or open the patient and scroll their timeline — the verification appears as its own entry with the full benefits breakdown. See Where do I see what insurance Amy verified? for a tour of that screen.
Note
Amy reads and reports benefits. She never interprets coverage as a promise of payment, and she never gives clinical or billing advice on the call — that always routes to your team.
If a check doesn't come back clean
Some plans aren't reachable electronically, and sometimes a member ID has a typo. When that happens Amy marks the verification as needing attention instead of guessing. Walk through the fixes in A verification failed — what do I do?, including the one-tap re-run.
Still need a hand?
Reach the Valian team any time at help@valiansystems.com, or open a ticket from the Help Center inside your dashboard. During onboarding, your onboarding contact is at onboarding@valiansystems.com.