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Eligibility & Benefits Verification

Eligibility & Benefits Verification from Soft Home Global costs $1,700 per seat per month. That is one full time trained person, forty hours a week, working United States business hours inside your own system. One seat, one month, cancel any time.

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Batch checks against tomorrow's schedule, captured in your system, exceptions flagged early.

Checks every patient's coverage the day before the visit and records the benefit details in your own system.

Video transcript

Eligibility & Benefits Verification: catches coverage problems early.
Verifies coverage the day before the visit.
Records copay, deductible and out-of-pocket amounts.
Coverage checked early, exceptions flagged to you.

What the seat actually does

Verification the day before, not at check-in
Benefit detail captured in your format
Copay, deductible and out-of-pocket recorded
Coverage terminations flagged to the front desk
Secondary and tertiary coverage identified

What it costs

$1,700

Per seat, per month, in US dollars. Full time, forty hours a week, on US hours — not per hour, not per claim, and never a share of your collections.

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The denial codes this seat works

18 codes, grouped the way the queue is worked rather than by number. Each one links to what causes it, the order to work it, and how to stop it recurring.

Worked by being fixed at coordination of benefits and rebilled

CO-22 — May be covered by another payer
The payer thinks somebody else is primary. Until coordination of benefits is corrected on their file, nothing on this claim will pay.
CO-27 — Coverage had already ended
The patient was not covered on the date of service.
CO-109 — Wrong payer or contractor
It went to the wrong place.
CO-119 — Benefit maximum reached
The patient has used up what the plan allows for this benefit in this period.
PR-31 — Patient not found as insured
The payer cannot match the patient to a member record. Usually a demographic or identifier mismatch rather than a coverage lapse.
CO-24 — Covered under capitation
The payer says this service is included in a capitated arrangement, so there is no separate fee-for-service payment.
CO-32 — Not an eligible dependent
The payer does not recognize this patient as a covered dependent on the subscriber’s policy.
CO-33 — No dependent coverage
The subscriber’s policy covers the subscriber only, so a dependent’s claim has nothing to pay against.
CO-35 — Lifetime maximum reached
The policy has a lifetime cap on this benefit and the patient has used it.
CO-177 — Eligibility not met
There is coverage, but the patient has not satisfied a condition the plan attaches to it.
N30 — Patient ineligible for service
The patient does not qualify for this particular service under their plan, even though they may hold coverage.

Worked by being corrected and resubmitted

CO-140 — Member ID and name disagree
The member ID and the name on the claim disagree with the payer’s record.
CO-9 — Diagnosis and age disagree
The diagnosis code you sent is one the payer only accepts for a different age group.
CO-10 — Diagnosis and gender disagree
The diagnosis code is one the payer only accepts for a different gender marker than the one on the claim.
N382 — Patient identifier invalid
The payer cannot match the patient from what was sent.
MA27 — Medicare number or name invalid
Medicare cannot match the beneficiary: the Medicare Beneficiary Identifier or the name on the claim does not agree with the entitlement record.

Worked by being appealed with clinical documentation

CO-96 — Non-covered charges
The plan does not cover this service at all. Distinct from medical necessity, which is an argument about evidence.

Worked by being verified against the benefits, then billed to the patient

PR-204 — Not covered by this plan
The service itself is excluded from this particular plan. This is a benefit design decision, not a coding error.

Working a denied claim costs $57.23 per denied claim in administrative time (source) and payers ultimately pay roughly 90% of claims even while using an initial denial to slow payment. The reason they sit is almost never that nobody knows how. It is that nobody has the hours.

How a seat starts

Every seat works from our office in Rawalpindi, Pakistan, on your hours, logged into your own system rather than ours. Some payer contracts and some state Medicaid programs restrict or require disclosure of offshore access — Medicare Advantage plans in particular require First Tier/Downstream/Related Entity oversight, which can mean disclosing us as a subcontractor — so check yours before placing a restricted queue on this seat. More on /security/.

You issue one named login. We sign the Business Associate Agreement before it is used. We agree the numbers you will judge the seat on, which you pick and you measure. Then we train for about a week on your workflow and the seat starts. Every Friday you get a written report of what was done, what the numbers were, and what went wrong.

The four steps in full →

Questions

How much does eligibility & benefits verification cost?

$1,700 per seat per month. That is a full time person, forty hours a week, working United States business hours. Not per hour, not per claim, and not a percentage of what you collect.

Is there a minimum contract?

One seat for one month, cancellable with thirty days notice. There is no annual lock-in.

Do we have to change systems?

No. The work happens inside whatever you already use, through a named login you issue. We do not sell software and we do not route your data through anything of ours.

How quickly can a seat start?

A named person starts 14 to 30 days after the agreement is signed and the first month is paid, on a date agreed with you in writing. That includes about a week of training on your workflow, your payer mix and your system, which is not billed on top.

Written by Ibtesam Asif · Last updated 2026-09-17

Prices and terms on this page are our own published terms and are what we will actually charge. Nothing here is a forecast of a result — not collections, not recovery, not a payback period.

Next step

Try one eligibility & benefits verification seat for a month

$1,700 for the month. If it does not earn its keep, cancel it. Twenty minutes on a call is enough to tell whether it fits.

Book a 20 minute call See the prices

Or write to ops@softhomeglobal.com