In development4 min read
Insurance workflow concepts
How eligibility checks and private-pay fallback are intended to work.
This is a product-direction guide. Described features may not be available yet.
Eligibility and booking
The proposed workflow checks coverage in advance and again near the appointment when supported. If verification is unavailable, staff may need to use a private-pay fallback rather than promising coverage.
Changes after approval
If coverage is later confirmed, an authorized staff workflow may adjust billing, refunds, or credits with proper reconciliation. Motor-vehicle and workers' compensation cases require distinct tracking.
Important limitation
Good to know
This section describes planned behavior. It is not insurance coverage advice, a guarantee of reimbursement, or a claim that electronic eligibility integrations are live.