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.