Insurance & verification · 4 min read · Beginner
How Amy verifies insurance in real time
When a caller gives Amy their insurance, she checks eligibility and benefits with the carrier during the call and saves the answer to the patient's record. No phone tree, no callback.
Updated Oct 2, 2026
When a caller gives Amy their insurance, she checks it the moment she has what the carrier needs, 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 carrier in real time and the answer is saved to the patient's record in seconds.
Tip
Amy checks insurance live on a call. Nothing runs on a schedule: insurance that reaches you any other way (a card photo, a form) is saved to the patient's file, and your team runs that check with one click on the Verification tab. 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 carrier the same questions your team 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 carrier returns them
The steps, start to finish
- Amy collects the essentials on the call: carrier, member ID, the policy holder's name, and date of birth. If the caller is on someone else's plan, she captures the policy holder too.
- The request goes to the carrier in real time through Valian's clearinghouse connection. Most carriers answer in a few seconds.
- The answer is saved to the patient's record, dated, with the carrier's response. You read it on the Verification tab.
- A check that does not pass is flagged for your team in the red Verifications with a problem strip at the top of the Verification tab, so nothing silently falls through.
Where the result shows up
Open the Verification tab and find the patient: the latest answer opens right on their row, and View the full benefits report shows everything, including every earlier check. 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 the check is marked as needing a fix instead of guessing. Walk through the fixes in A verification failed, what do I do?.
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.