Sohar Health

Automatically checks patient insurance coverage status and active benefits in real-time by connecting to insurance carrier systems. Eliminates manual phone calls and reduces verification time from hours to seconds.

Extracts specific coverage information including deductibles, copays, coinsurance, out-of-pocket maximums, and session limits directly from insurance policies. Provides comprehensive benefits summary without manual policy review.

Identifies whether specific behavioral health services require prior authorization from the insurance carrier before treatment can begin. Automatically flags services that need pre-approval to prevent claim denials.

Analyzes patient insurance coverage, treatment codes, and plan requirements to predict likely claim denials before submission. Flags high-risk claims and suggests corrections to improve acceptance rates.

Automates the entire insurance verification process from patient intake through eligibility confirmation, eliminating manual steps and reducing administrative burden on clinical staff. Integrates with practice management systems to streamline data flow.

Identifies missed revenue opportunities caused by incomplete insurance verification, uncollected patient balances, and claims that could be resubmitted. Highlights specific cases where revenue can be recovered.

Calculates and communicates patient out-of-pocket costs based on verified insurance coverage, including copays, deductibles, and coinsurance. Provides accurate financial estimates before treatment begins.

Maintains active connections with multiple insurance carriers' systems to pull real-time eligibility and benefits data. Automatically syncs and updates insurance information to keep verification data current.

Validates that treatment codes, service descriptions, and documentation comply with behavioral health billing standards and insurance requirements. Ensures claims use appropriate behavioral health-specific codes.