Streamlining Care with Accurate Benefits Data: How Nirvana Helps Providers Verify Eligibility in Seconds

Providers can avoid as many as 81% of claim rejections with easy upfront verification of patient eligibility.

Today, verifying patient eligibility is incredibly complicated. Once a patient books an appointment, administrators are caught in an endless loop of manual tasks — chasing down insurance details from patients and payers, submitting claims without certainty that the coverage information is accurate, and handling costly, time-consuming resubmissions once a claim has been denied. What should be a straightforward process instead turns a single appointment into hours of administrative work — all just to ensure a provider can get paid for care they already delivered.

Nirvana gives healthcare providers the ability to stop this cycle before it begins by putting reliable, instant coverage data at their fingertips so they can focus on delivering exceptional care.

Immediate Benefit Verification: The Key to Seamless Operations

For years, practices have carried the burden of an insurance verification system designed in the 1970s.

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The Old Way

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• Manual verifications trap your team in an endless cycle of phone calls and follow-ups
• Confusing policies and outdated portals keep providers in the dark about what's covered
• Claim denials caused by incomplete or inaccurate patient information
• Data input by hand leads to unreliable insurance details and eligibility verification errors

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Nirvana's real-time verification solution addresses these challenges at the source. With Nirvana, providers can confirm coverage with as little information as the patient's name, date of birth, and ZIP code. We give our staff the ability to instantly see all the information they need to guide patients to appropriate care options and share clear estimates about out-of-pocket costs — before treatment begins.

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The Nirvana Way

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• Instant verification provides real-time coverage information that's highly accurate, even with typos caused by manual input
• Transparent eligibility data includes copays and deductibles for true out-of-pocket expense
• Accurate upfront cost estimates unlock up to 86% faster DSO and enable pre-visit collections
• Up to 300% boost in efficiency with less time spent on verification, billing, and resubmission

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Just like preventive care protects patients from future complications, a dedicated tool like Nirvana ensures instant coverage verification, catching eligibility gaps before they affect your practice.

The result? Better operational and financial health, keeping your practice running like clockwork.

Here's how:

Instant Access to Up-to-the-Minute Eligibility Data

Nirvana searches hundreds of payers in seconds, delivering:

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• Accurate coverage confirmation: Providers can confidently submit claims knowing they will be reimbursed for the care they are providing.
• Upfront cost estimates: Nirvana's machine learning models interpret plan details from hundreds of payers while in-house expert billers consistently verify data against new insurance schemes and policies. This approach unlocks nuanced cost estimates that account for every detail, like whether a patient has secondary health insurance or has reached their session limits.
• Fewer claim denials: Reduce claim denials by up to 30% with real-time eligibility data that detects errors before claims are submitted and automatically corrects mistyped inputs.

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By providing accurate coverage and cost-share data at the time of booking, you enhance the patient experience, reduce sign-up drop-offs, and bring new patients to your practice. Providers gain clarity on what to charge while patients understand their financial responsibility — enabling pre-visit collections and accelerating payments for a more efficient revenue cycle.

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Improving Administrative Efficiency with an Easy-to-Use Eligibility Management Platform

On average, manual verification adds four hours to a healthcare worker's day. Many patients submit intake forms with missing payer information, leading to claim rejections that require staff to track down insurance details, correct errors, and resubmit denied claims — wasting valuable time and resources.

Nirvana's eligibility management platform eliminates these inefficiencies. Its advanced AI consolidates coverage and cost data from multiple systems into a single, easy-to-use dashboard, proactively flagging coverage risks before they become denials. By automating these processes, Nirvana can boost team efficiency by up to 250%, allowing staff to focus on high-priority cases.

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Easing Operational Costs

Every year, practices lose a collective $12.8 billion due to inefficient verification processes. With instant benefit verification, they can capture their share of these potential savings by boosting team efficiency, minimizing costly denials, and booking verified, billable appointments.

Consider a patient who attends weekly therapy sessions. After switching jobs, they receive new insurance coverage but forget to inform their provider. When they submit a claim using old insurance information, it's instantly denied.

In moments like these, providers can set up real-time alerts to help your team stay on top of eligibility and costs throughout the patient journey. So, instead of patients' claims getting denied due to unexpected insurance changes, providers can proactively check on coverage and see flags prior to appointments. Information is always up-to-date, and patients can continue treatment without interruption.

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All of this helps practices support operations and expand access to care. For example, reprocessing a single claim costs around $57.23 and accounts for 90% of the amount spent processing claims — that's money that could be reinvested in advancements for your practice, like new equipment, more providers, or facility upgrades.

Nirvana Keeps Patients and Practices Healthy with Instant Eligibility Verification

Nirvana empowers over 11,000 providers to provide exceptional patient care by providing trustworthy, up-to-the-minute benefits data that's highly accurate.

Providers benefit throughout the patient's care journey from Nirvana's pinpoint accuracy and proactive alerts. Our platform makes it easy to notice benefit changes before they disrupt treatment or derail your revenue cycle.

This always-on eligibility monitoring has helped leading practices achieve some impressive outcomes:

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• Faster appointment scheduling: Using Nirvana, Geode Health accelerated their verification process, enabling patients to schedule appointments within 24 hours with accurate upfront estimates.
  
• Increased access to care: With Nirvana supporting their pre-session collection policies, Resilience Lab increased their client base by 74% with 95% accurate pre-session patient obligation estimates.
  
• More efficient claim processing: Nirvana's smart recommendations helped one of the largest behavioral health organizations in the country identify over 21,000 potential claim rejections. As a result, the practice strengthened its revenue stream while boosting biller efficiency by over 110%.
• Faster reimbursement: Correctly filing claims the first time dramatically reduces DSO. Take Resilience Lab — using Nirvana, they cut their DSO to eight days (compared to the industry average of 45-60 days).

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Ready to transform your practice's performance and patient experience? Book a demo today.