FROM CLEARWAVE

Multi-Factor Eligibility™

Take the hassle, inaccuracy and lag time out of patient insurance eligibility checks with real-time verification, and get paid faster.

Health Insurance Verification Built to Boost Your Wallet

Faster Payment Determination, Collections and Reimbursement

Clearwave's Multi-Factor Eligibility™ drives cleaner data, reduced claim rejections and instant co-pay determination — meaning more money in your pocket. Don't just keep up, accelerate your cash flow while reducing the hours it takes for staff to verify insurance — you can even reallocate those FTE resources to other areas of the practice. Present the most accurate co-pay at every patient check-in, increasing collections by 112%, while reducing claim rejections by 94% and workloads by 2x.

Reduce Claim Rejections

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Reduce Claim Rejections

Drive accuracy in claims processing to stop reimbursement challenges before they happen. Clearwave’s Mult-Factor Eligibility™ software automatically runs eligibility multiple times on every patient, including on the day of service, and can drill down to the plan level, showing staff only the information relevant to them. As a result, your practice never has stale insurance data and can correct errors faster, enabling you to reduce claim rejections. Practices have seen a 94% drop in claims rejections — putting profits back into their pocket!

  • 7x Verification to Reduce Errors: When practices only run eligibility once, 3-5 days before a patient appointment, they often face a higher rate of claim rejections due to data errors that were never spotted and corrected before claim submissions. Clearwave runs eligibility on average 7 times per patient engagement to catch insurance errors before they impact claim submissions, helping your practice increase reimbursement.
  • Auto-resubmit insurance without staff involvement: Clearwave automatically resubmits errored transactions with available patient data, increasing the number of active insurances returned and improving your ability to collect accurate co-pays and process clean claims — without burdening staff.
  • Saved Transaction Details: 271 transaction details and benefit information are stored for 12 months, giving you access to the information you need.

Save Hours of Time

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Save Hours of Staff Time

Free your staff from the time-consuming tasks associated with eligibility verification and reduce errors with greater data accuracy. Clearwave’s Multi-Factor Eligibility™ verification drops the time it takes to verify insurance by instantly determining all-patient benefits, meaning staff no longer have to confirm benefits on a patient-by-patient basis. With Clearwave’s presentation of data and simple flagging system, staff seamlessly narrow their focus only on the patients with insurance discrepancies that require their attention — dropping verification workloads by hours. The centralized scheduling view in the dashboard removes the need for staff to toggle between multiple payer portals or patient accounts. With time saved, practices can reallocate staff resources and FTE spending to other areas.

  • Payer-Appointment Mapping: Clearwave automatically maps payers to appointment types, matching and inputting the correct co-pay amount to patient accounts without staff involvement. 
  • Quick Resubmissions: Once staff update patient insurance to solve issues they can quickly resubmit insurance and see updates, all with the click of a button. This simple step also helps staff check insurance for back-end billing needs like claim submissions or global-period-of-care reimbursement.
  • Easy-to-use Dashboard: Clearwave normalizes the different payer responses and only presents the information that is relevant to your specific specialty. With one click, staff can drill into individual patient insurance information like remaining deductible, co-pay, plan name/type, conflicts between patient entry and payer response, Medicare/Medicaid and more.

Increase Co-Pay Collections

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Increase Co-Pay Collections

Clearwave’s Multi-Factor Eligibility™ runs automatically and verifies insurance at every critical patient interaction to ensure coverage has not lapsed, all without added fees per transaction. Clearwave also automatically maps payers to appointment types, matching and inputting the correct co-pay amount to patient accounts — reducing manual errors and the need for refunds or future co-pay collection efforts. As a result, practices see immediate improvements to co-pay collection and no longer need to register at payer sites or send staff to call on patients or payers.

  • Present Co-Pays at Every Check-in: During registration, Clearwave will automatically present the most accurate co-pay to patients, meaning you can ask for payment at each check-in, helping you increase collections every day.

  • Reduce Refunds & Credits: With the most accurate eligibility engine on the market, your practice will reduce the challenges associated with collecting too little, too much or worse, not at all, at check-in.  
  • Quickly Determine Vision Co-Pays: Clearwave will determine when to collect from the Vision co-pay vs. medical, in real-time, to streamline collections and reimbursement for ophthalmology practices.

Boost Self-Pay & Medicaid Payments

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Boost Self-Pay & Medicaid Collection

Clearwave’s Multi-Factor Eligibility™ enables practices to check self-pay patients against Medicaid in real-time or in a batch each month. Clearwave also allows practices the option to set up custom self-pay rules that enable you to collect your desired self-pay amount at patient check-in, automatically. Increase reimbursement and make it simple, quick and easy for your practice to boost profits every day.

  • Simplify Collections: Collecting payments from self-pay and Medicaid patients shouldn't have to fall to the wayside, with Clearwave it won't. Clearwave provides the built-in insurance verification approach practices require to boost self-pay collection, automatically. 
  • Meet Your Unique Self-Pay Standards: Clearwave's flagging system and registration workflows can both be customized based on your practice's pre-determined self-pay collection process. Collect the way you always have, just digitally and without staff intervention.
  • Leverage the Most Connected Payer Network: Clearwave pulls insurance data from multiple clearing houses and has connections with over 900 payers, which means instant responses from over 95% of your payers.

Fast, Accurate Health Insurance Verification Software

Switching to Clearwave Eligibility Saves Time & Money

When practices implement Clearwave Eligibility they see immediate and long-term results.
From staff cost and time savings to dropping claim rejections, see what your practice could be missing out on!

$K

Additional Revenue Per Provider

By reducing no-shows, dropping claim rejections and increasing collections at the point-of-service.

%

Drop in Claim Rejections

With faster eligibility verification and improved patient data capture, solving issues before they halt revenue.

+

Staff Hours Saved

By reducing workloads and reallocating eligibility and benefits employees to other areas, while reducing backfill needs.

Clearwave's Health Insurance Verification Benefits

Get Paid More & Drop Costs

Stop chasing down co-pays after patients come in for their appointments and reduce refunds, resubmissions and other overhead costs. Help your practice do more, with less staff involvement and billing setbacks — see what your practice is missing without Clearwave Multi-Factor Eligibility.

Accelerate (1)

Accelerate Self-Pay
Determination & Collection

Collect your desired self-pay amount at check-in by incorporating your unique, pre-determined self-pay rules into your automated approach.

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Increase Collection From
Medicaid Patients

Clearwave Multi-Factor Eligibility enables practices to check self-pay patients against Medicaid, in real-time, helping you boost collections every day. 

Benefits (1)

Check Patient Benefits
During Scheduling

While patients self-schedule or talk to the call center, your practice will know if the patient's insurance is active and accurate, with real-time eligibility checks via Clearwave Scheduling.

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See All Patient Information
In One Simple View

Clearwave's dashboard offers a comprehensive overview of patient coverage details, enabling quick identification of insurance discrepancies through a user-friendly flagging system, allowing instant access to individual patient insurance information with a single click.

Information (1)

Focus Solely On Patient
Insurance Discrepancies

Why have staff look into every single patient's insurance information, when you could focus them only on the patients with insurance issues that require action? With Clearwave, your staff can focus only on the patients with insurance discrepancies that demand their attention.

Responsibility (1)

Estimate Patient
Responsibility Instantly

Use real-time eligibility deductible information for estimations and determine patient responsibility up-front for scheduled services. See how you can build a click-of-a-button estimations approach!

See the Power of the Clearwave Dashboard

   

Reconciles today's patients in one single view.

See E&B Report, Co-pay, Data Conflicts and HMO Payers.

E&B data displays based on the service being performed.

Includes eligibility status and flags insurance errors.

Filters to show only the patients with eligibility exceptions.

Displays vision insurance and associated co-pay.

eligibility dashboard

  

“Our practice management system only got us 65% of the way to verification. Clearwave gets us 95% of the way there, which dramatically cuts down the burden on our front-desk staff.”

94% reduction

in claim rejections

$17.50/Claim

savings from not having to resubmit claims

$400K

in new Lasik revenue

“Before Clearwave, our staff had to call patients prior to their appointment to ask for their co-pay, and we didn’t always get a straight answer, meaning we would collect too much or too little. Now, we have accurate co-pays that are proactively determined by Clearwave. We know exactly what to charge the patient when they come in and patients can make that payment on the kiosk during check-in.”

90% reduction

in check-in times

95%

ongoing patient utilization of self-registration

61%

copays collected monthly

“Since implementing Clearwave, we’ve seen an incredible return on our investment. Patients have effortlessly adapted to using kiosks. Our rejected claims have dropped by approximately 20%. Our point-of-service collections at the kiosk have increased by roughly 78%.”

20%

reduction in claims rejections

78%

increase in point-of-service collections

99%

patient utilization at Clearwave Kiosks

Frequently Asked Questions

About Health Insurance Eligibility Verification Software

Get answers to common questions about verifying patient insurance benefits.

Verifying health insurance eligibility ahead of each appointment is critical for avoiding coverage gaps, reducing denied claims and building patient trust. Each year, millions of patients experience insurance changes, many without realizing their coverage has shifted. Healthcare Finance states that “eligibility expired” is one of the top five reasons medical claims are denied.  

According to additional recent reporting, 21.5% of insured patients experience insurance turnover annually due to job changes, and 2% experience a change every single month. The issue peaks in December, when 13.4% of patients—and 23% of those age 64—undergo insurance changes, often from Medicare enrollment or employer plan shifts. These changes can be easy to miss and can cause serious bottlenecks at check-in if eligibility isn’t re-verified in advance.

By verifying benefits 3–5 days before a visit and again on the day-of, practices can minimize last-minute scrambles and maximize collections. Automated medical eligibility verification software ensures that patient insurance is verified well in advance, regardless of how frequently it changes—helping staff identify issues and update records before they impact the revenue cycle. 

How often does patient insurance change?

  • 21.5% of insured patients change insurance yearly due to job turnover
  • 2% of insured patients change monthly
  • 13.4% of insured patients change insurance in December
  • 23% of insured patients aged 64 change coverage in December

Additionally, 25% of insurance changes stem from employers switching insurers, while 75% stem from employees leaving employers.

All this to say — change is happening constantly.

Here’s why verifying patient insurance benefits early matters:

With rising deductibles and changing coverage policies, patient eligibility can change frequently—and failing to catch those changes can significantly impact your bottom line.

  1. Reduce claim denials and payment delays by confirming plan coverage, deductibles, co-pays and coinsurance upfront
  2. Improve patient experience by avoiding surprise bills and ensuring transparency
  3. Save staff time by eliminating day-of verifications and prior authentications that slow down check-in
  4. Boost front-desk collections by pre-loading known balances and eligibility data into the system

See when to verify a new patient's insurance and the cadence at which you should re-verify patient insurance automatically in order to reduce the chances of a patient falling through the cracks. This article covers the top tips to consider. 

Best practice: Automate this process with robust health insurance verification software so staff don't have to run manual checks across payer portals.

With Clearwave Eligibility, practices can stay on top of changing patient insurance while also saving staff 500+ hours per year. This quick action and time savings are critical across specialties, but essential in areas like oncology where patients are coming in multiple times week for critical treatments. Rachelle Tonga, Director of Administrative Services at Utah Cancer Specialists shared, “Clearwave has put a stop to our prior authentication challenges. If there’s an insurance change, we know about it and we can act on it. It’s been a huge relief for our billing and claims processes.”

Going on, “Now, during pre-check or at the kiosk, patients have to answer the questions to go to the next screen. If their insurance is expired, the system will prompt patients to update their information and it will notify our staff. It’s astounding how accurate our data is now.”

Medical eligibility verification software, like Clearwave, dramatically shortens the learning curve for new staff, streamlines workflows and improves data accuracy. Practices no longer need to manually train staff on each insurance portal or plan type—automation handles the heavy lifting.

Key benefits of Clearwave's leading medical eligibility verification software include:

  • Automated verifications for every appointment, run in real-time and in batches, with no added fees
  • Centralized dashboards to view insurance responses and coverage details at a glance and narrow in on patients that require staff attention
  • Standardized tasks and flagging systems that eliminate guesswork and reduce confusion for new and existing staff
  • Minimized manual errors, which reduces time spent on back-and-forth payer calls

Practices report that Clearwave reduces onboarding time for new front-desk staff by weeks—allowing them to focus on more patient-facing tasks sooner. Clearwave's Eligibility software helps protect practices from staff turnover gaps, especially during busy seasons, by preserving a consistent and automated verification process.

This transformative impact is clearly illustrated by Tiara Williams, Patient Registration Manager at Jordan-Young Institute, who shares, “We didn’t realize how much Clearwave would help us catch the little details, ones that we wouldn’t have been able to catch before. Patients may be off by a number when writing down their information or could easily put in the wrong insurance card. The dashboard makes us aware of these issues so we can proactively solve them. We have a lot less errors, which shows that our previous claim rejection challenges could have been prevented with Clearwave.”

Learn more about using medical eligibility verification software to reduce training time and improve staff efficiency! Here are helpful articles:

Clearwave’s patient insurance verification software improves both financial outcomes and staff productivity. By verifying eligibility well in advance and updating patient records in real time, Clearwave enables practices to collect more at check-in and reduce rejected claims and billing stalls later on — all while saving hours of staff work. 

Here’s the impact Clearwave clients have seen:

  • 500+ staff hours saved per year by removing manual verification steps (see the full breakdown)
  • Increased point-of-service collections with better visibility into copays and deductible balances
  • Reduced claim rejections by spotting and solving errors fast to confirm active coverage before the appointment
  • Less rework for billing teams with more accurate patient records from the start

See what Clearwave Clients are saying:

“The eligibility dashboard has been critical in helping us quickly identify patients with Medicare Advantage plans. Clearwave will alert us of patients with a Medicare plan and that flag alone is probably one of the most helpful because about 55% of our patients have some type of Medicare insurance.” - Revenue Cycle Operations Manager | Carolina Orthopaedic & Sports Medicine Center

“The Clearwave Eligibility flagging system and dashboard have helped us reduce our denials. Clearwave gives us a way to understand insurance errors so we can proactively solve them, which helps us collect more at check-in and reduce claim rejections and denials on the back end.” - Insurance Verifier Lead | The CardioVascular Group

“Clearwave will tell us anything that's wrong. For example, the dashboard will tell us if a subscriber is incorrect and even the name of the subscriber. It will indicate if a self-pay patient actually has a Medicaid policy, so we know how and what to collect. At the front desk, it’s helpful to have all of the daily patient information in one, easy-to-use dashboard.” - Tiara Williams Patient Registration Manager | JYI

See why specialty practices choose Clearwave's award-winning eligibility solution.

There are often hidden costs associated with manual—staff-only—verification or lackluster eligibility tools.

Traditionally, practices rely on billing and administrative staff to verify patient insurance, benefits and co-pays. To do this, they must call insurance companies or patients to check benefits, sift through large packets of information, search on payer websites, answer questions from insurers and patients and reconcile any discrepancies along the way. Think about the days when you’re short-staffed due to sick calls, or the Monday morning crunch after a weekend’s worth of appointment requests. Manual verification tasks only add to the complexities and slow down front desk and billing workflows.

Alternatively, practices that rely on limited health insurance verification software often find they still need staff to do the heavy lifting, defeating the purpose of automation. 

Any mistakes or missed opportunities due to your current process could lead to:

  • Inabilities to collect co-pays at check-in
  • Higher investment in administrative training
  • Uncertainty about what’s owed at check-in
  • Inaccurate co-pay collections at check-in, leading to write-offs, debits and credits
  • Increased claim rejections and resubmission fees
  • Slow check-in processes, increasing patient wait times
  • After hours and overtime for E&B workers, and increased costs

When roadblocks like these get in the way, the insurance verification process can be a major headache and source of frustration for all involved. High-growth healthcare practices are overcoming these challenges by modernizing their approach with insurance eligibility verification software. 

See how Clearwave helps clients overcome these challenges by fully automating the process and providing staff with an easy-to-use insurance verification dashboard. Take an interactive demo right now!

Mult-factor insurance eligibility software runs eligibility multiple times on every patient, including on the day of service, and can drill down to the plan level — showing staff only the information relevant to them. This view is what can save staff hours in a day.

A solution with multi-factor eligibility™ will run automatically and verify insurance at every critical patient interaction, from scheduling to check-in and beyond, all to ensure coverage has not lapsed and without added fees per transaction. As a result, your practice never has stale insurance data and can spot and correct errors faster, enabling them to collect accurate payments when a patient checks in.

Traditional health insurance eligibility verification often returns inconsistent or incomplete data, leading to increased staff intervention, claim denials and missed revenue. 

Clearwave’s medical eligibility verification software solves for these challenges by performing multi-factor verification automatically and in real-time, ensuring cleaner claims and accurate collections at check-in.

Here’s how Clearwave's medical insurance verification software works:

Clearwave’s Multi-Factor Eligibility runs automatically at multiple patient touchpoints, including scheduling, pre-registration, in-office registration and more. It’s built into the workflow to run automatically at various points along the patient’s journey and each time, it pulls insurance data from multiple clearing houses and more than 900 payers.

Beyond proactive, automated insurance eligibility checks, in Clearwave, patient eligibility verification can also be re-run at any time without added fees. Clearwave’s Eligibility software combines proactive insurance checks with a real-time eligibility dashboard that provides staff with a holistic view of patient coverage details.

The dashboard is where administrative staff can review patient insurance details in one centralized scheduling view, rather than toggling between multiple payer portals or patient accounts in your practice management system or electronic health record.

For example, within one click in the Clearwave Dashboard, practice staff can see:

  • Remaining Deductible, Appropriate Copay – Primary Care, Specialist, Urgent Care, or Outpatient
  • Plan Name / Type
  • Data Conflict Discrepancies between patient entry and payer response
  • Managed Care / Independent Physician Association information for HMO/Medicaid plans
  • Medicare Secondary and Reason information with Coordination of Benefits Date
  • Medicare Advantage Information
  • Home Health / Hospice Health Information

This layered method is crucial because even small discrepancies can trigger claim rejections. With multi-factor eligibility verification, practices gain more reliable data, reduce manual corrections, and can confidently collect at check-in. As the blog emphasizes, this approach “goes beyond the basic yes/no eligibility check” to protect your revenue and improve the patient experience.

See how Clearwave helps clients overcome these challenges by fully automating the process and providing staff with an easy-to-use insurance verification dashboard. Take an interactive demo right now!

Proven Medical Insurance Verification Software

How Clearwave's Multi-Factor Eligibility Benefits Practices

See the real-world impacts of Clearwave's health insurance eligibility verification software.

Utah Cancer Specialists Put a Stop to Patient Insurance Setbacks

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CVG Reduces Claim Rejections & Improves Patient Experience

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Thomas Eye Group Case Study

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