How a check runs
One patient in real time, or a batch, with the raw 271 kept beside every answer.
Eligibility and benefits in the docs →- Step 1Send the check
- One request names the payer, the provider and the patient. Check one patient in real time, or send a batch.
- Step 2Daybook runs the 270/271
- The 270 goes to the payer through the clearinghouse, with no portal login, and the 271 is read into fields. Coverage reads active, inactive, not found or unavailable, and a payer's AAA rejection comes back as an answer of its own.
- Step 3The answer
- A real-time check answers in the response. A batch sends one event per patient. The raw 271 is kept with every answer.
- Step 4Watch for changes
- A recheck that finds different coverage tells your system so, and an answer that needs a person opens a coverage work item for your biller.
For medical billers
Coverage changes between the visit and the claim. Daybook rechecks every submitted, accepted or in-process claim that has coverage on file and no check for that patient and payer in the last 7 days. A not active answer opens a coverage work item on the claim, assigned to the biller who owns that payer.
- Real-time 270/271 checks through Stedi or Optum, with no portal login
- Rechecks on every open claim with coverage on file, no more than once in 7 days per patient and payer
- Health plan coverage by default, or a professional office visit, mental health, psychotherapy, MRI and CT scans, or urgent care on request
- Medicaid answers that carry the managed care plan, lock-in, spend-down, aid category and dual status, read by each state's companion guide
- A phone call to the payer when the 271 is not enough
More for medical billers: the billers page and eligibility verification software for billing companies.
For dental billers
Dental benefits are the first question of every visit. Daybook reads the benefits breakdown before the visit and shows the coverage status, the plan and its dates, and the benefit rows, each with its coverage level, network, time period, amount and whether authorization is required. An answer that needs a person goes to your biller's coverage queue, and the check runs again in one step.
- The benefits breakdown read before the visit, over 270/271
- Each benefit row with its coverage level, network, time period, amount and whether authorization is required
- An inactive plan or a payer that could not answer opens a coverage issue, and the check runs again in one step
- Where a payer shows benefits only in its portal, Daybook handles the sign-in and the two-factor code, and where nothing electronic answers, it calls the payer
- Member IDs on every check sealed
More for dental billers: the dental page and dental insurance verification software.
Starts from your knowledge base
Your billing company's own rules, appeal workflows, payer quirks and call scripts are what Daybook runs. You send the documents, Daybook imports them as payer guides, shows you what it produces, and you adjust it together on a call. Each solution runs on its own, so you start with one and add the next.
For eligibility that is what your front desk and your billers do before a visit, and again while a claim is open.
- The benefits your front desk needs before the visit
- Your recheck rule for open claims
- What a not active answer opens for your team
Where it shows up
- The claim or the visit in your PM or EHR
- Coverage, the plan, its dates and the benefits, as fields
- A signed webhook
- eligibility.completed, and coverage.changed when a recheck finds different coverage
- The Daybook dashboard
- A coverage work item when the answer is not active
Check coverage from your own system
One request runs a real-time 270/271 and answers in the response. A batch answers by signed webhook, one event per patient, and a recheck that finds different coverage tells you so.
Read eligibility and benefits in the docs →Frequently asked questions
What billing teams ask us about eligibility and benefits, and our answers.
Is Daybook's eligibility check real time?
Yes. The 270 goes to the payer in real time through the clearinghouse and the 271 comes back in the response, as plain fields with the raw 271 kept beside them. A batch answers one event per patient.
What does the answer contain?
Whether coverage is active, the plan, its dates, what is left of the deductible and the out-of-pocket maximum, and the copay and coinsurance as numbers. Coverage reads active, inactive, not found or unavailable, and a payer's AAA rejection comes back as an answer of its own, so your biller sees what the payer said.
What happens when coverage is not active?
A not active answer opens a coverage work item on the claim, assigned to the biller who owns that payer, and a recheck that finds different coverage from the last one tells your system so. Your biller decides what to do with the claim.
Can Daybook check Medicaid eligibility?
Yes. For Medicaid the answer carries the managed care plan the member is assigned to, lock-in, spend-down, aid category and dual status, read by each state's companion guide.
Can dental insurance be verified without logging into every portal?
For a payer that answers over 270/271, the check needs no login at all. Where a payer shows benefits only in its portal, Daybook handles the sign-in and the two-factor code, and where nothing electronic answers, it calls the payer.