How does CPT code level verification improve accuracy?

CPT code level verification checks benefits for each specific procedure, not just general eligibility and coverage by STC (Service Type Code). This prevents claim denials caused by missing coverage details or authorization requirements for the specific procedure.

Why combine portal checks with payer calls?

Portals provide basic coverage information, but calls reveal specifics like prior authorization requirements, visit limits, and the copays and coinsurances that apply to that specific CPT code. Using both portals and calls ensures complete, accurate benefits verification.

How are payer discrepancies identified and resolved?

Fuse compares portal and call results to identify inconsistencies. Discrepancies are flagged for review in our dashboard and in the summary that we produce for each check that can be inputted into your EMR/EHR.

Can this system identify coverage limitations?

Yes, Fuse identifies coverage limitations, prior authorization requirements, and visit limits at the CPT code level, reducing costly eligibility-related claims denials by pulling detailed benefit information from both payer portals and direct calls.

How can network status be confirmed?

Fuse uses direct verification calls to confirm network status and make sure there are no surprises when claims are adjudicated and patients need to be billed for rendered services.

How much time can I save by automating benefits checks?

Manual eligibility and benefits checks can take billing teams anywhere from 15 minutes to 2 hours depending on data complexity and payer hold times. Fuse automates this entire process, reducing administrative time by up to 95%.

What is the financial benefit of automating benefits checks?

Benefits include admin overhead savings of up to 30 min per patient, prevention of up to 20% of denials caused by incorrect eligibility checks, and faster patient intake to help grow revenue.

CPT-LEVEL
BENEFITS
CHECKS,
DONE BY AI

Checking portals and calling payers is a huge administrative strain on your team, and leads to patient billing errors. Let AI check portals and call payers so you don't have to.

Book your free demo

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"With Fuse, we feel empowered and more in control when working with payers."

Cathy, PhD and Co-Founder of Alaska Telepsychology

"We spend more time with patients and can give peace of mind that visits will be covered."

Zsante, Office Manager at Thrive Integrative Medicine

Automatic Summaries =
Hours Saved

Auto-generate billing summaries and insurance verification results at the CPT code level, confirming coverage details and network status before visits while reducing administrative work and errors.

Fuse insurance verification workflow screenshot

HIPAA-Compliant Healthcare Automation Platform

Fuse is HIPAA and SOC 2 Type II certified. We follow best practices for secure data handling to deliver enterprise-grade compliance, so your data is always protected.

CPT-LEVEL BENEFITS CHECKS,DONE BY AI

Checking portals and calling payers is a huge administrative strain on your team, and leads to patient billing errors. Let AI check portals and call payers so you don't have to.

Book your free demo

By providing us with your information you are consenting to the collection and use of your information in accordance with our Privacy Policy.

HIPAA-Compliant Healthcare Automation Platform

CPT-LEVEL
BENEFITS
CHECKS,
DONE BY AI