FeaturesCoverage

Most denials are decided before the visit starts.

Practice leaders name denials the biggest leak in the revenue cycle. The causes cluster at registration, eligibility, and authorization — none of which happen in billing.

Real 270/271Not a stored “verified in March” flag

Plain languageMember not found, inactive, plan mismatch — with what to do

Directory firstA payer not in the directory never goes to the wire

Screenshots are the synthetic demo. No real patients.

The day schedule with coverage chips on every visit — ELIGIBLE, SELF-PAY, or a reason. — Re-check eligibility (N) sweeps the unverified and ineligible for the whole day. From the synthetic demo at demo.chartvoyant.com — no real patients.

Check-in Readiness rail with coverage and eligibility rows computed from the chart when the page opens. — Insurance at check-in is a searchable directory of this practice’s payers, not a free-text box. From the synthetic demo at demo.chartvoyant.com — no real patients.

How it runs

01Run it todayA 270/271 against the card in front of you, not the one from March.
02Say it plainlyEligible, self-pay, or the payer’s reason and the one thing to do.
03Directory firstA payer that is not on this practice’s roster never goes on the wire.

What it is

Eligibility in ChartVoyant is an X12 270/271 against the coverage on the chart today. Each appointment shows ELIGIBLE · the payer, SELF-PAY, or an amber/red reason — no coverage, no member ID, inactive, unverified. Clicking a chip re-runs the check for that patient. Re-check eligibility (N) in the toolbar sweeps the unverified and ineligible for the whole day, and hides itself when the day is clean.

On the clinic floor

The clearinghouse identifier rides with the coverage, which is what eligibility and the claim both need. An eligibility check that comes back anything other than “eligible” explains itself in the payer’s own words, translated: member not found, plan mismatch, coverage inactive, provider not recognized — each with the one thing to do about it, and whether re-running the check unchanged can ever work. That is the AAA03 catalog turned into a desk instruction, not a raw code.

The demo is seeded so the day is mostly ELIGIBLE, with a couple of patients left UNVERIFIED or INVALID so the chip walkthrough still has something to click. Self-pay is a first-class coverage, not a failed eligibility. Stedi is the clearinghouse path; production eligibility is a BAA’d go-live, and the public demo remains synthetic.

What AI does, and what a person confirms

AI: read cards & check eligibility drafts coverage from a photographed card, matches the directory, and runs the same 270 the button runs. Staff confirm the extract. A payer that is not in the directory is never sent to the wire — that is a PHI and a billing safeguard, not a UX inconvenience. Eligibility agents may run when an appointment is booked; they are administrative and reversible.

Non-Device CDS

Eligibility is coverage, not care. No eligibility result is a treatment recommendation. If a plan would rather you try physical therapy first, that is a prior-auth rule for a clinician to document — not a diagnosis from a model.

Where this sits vs bolted-on tools

A payer portal that is not the chart produces a screenshot in the patient’s folder and a claim that still goes out wrong. ChartVoyant’s 271 is on the visit row, the check-in rail, and the 837. That is the entire feature.

Click the amber chip

The synthetic day board is mostly eligible on purpose, with a few bad chips left to teach the walkthrough.

Try the live demo Book a walkthrough

Keep reading

Check-in knows what’s leftCoverage is a readiness row, not a surprise at checkout. The claim should leave with the visitThe 837 is only as good as this morning’s 271. The day is a boardThe chip is on the visit before anyone rooms the patient.