New — Day-of-Service Coverage Check
Is Your Patient Part A or Part B Right Now?
Insurance gets verified at intake. But between that verification and today's visit, the patient could have been admitted to a SNF. The moment that happens, Part B billing for wound care becomes a denial. Medipyxis now catches that before your clinician applies the graft.
Real-time
Day-of-service check
not just intake verification
Audit log
Every check recorded
timestamped, append-only, defensible
Guidance
Advises, never blocks
the clinician stays in control
The Problem Intake Verification Can't Solve
Insurance verification at referral intake tells you a patient has coverage. It doesn't tell you what changed between then and now.
Monday: Referral intake
Patient verified — Medicare Part B, coverage active. Referral accepted, visit scheduled for Thursday.
Wednesday: Patient admitted to SNF
A fall, a hospitalization, a transfer to skilled nursing. Medicare Part A kicks in. The patient's coverage status changed, but nobody in your practice knows it yet.
Thursday: Clinician visits, applies graft
The chart is compliant. The graft is documented. The IVR packet is perfect. The claim goes out to Part B.
6 weeks later: Denial
The claim is denied. During a covered Part A stay, wound care is bundled into the facility's payment. You did everything right except check the one thing that changed.
One Click. Before the Visit.
The Part A/B check runs from the patient's billing page inside Medipyxis. One click queries real-time Medicare eligibility data, cross-references admission records, and returns a clear answer — not raw EDI, not a probability, a plain determination with evidence.
Real-Time Eligibility Probe
Queries Stedi for current Medicare benefit status and SNF-specific benefit data. Returns deterministic results from the payer — no AI interpretation, no guessing.
Confidence Level + Evidence
Each check returns a confidence level and the source data behind it. The team sees exactly why the system reached its determination.
Change Detection Alert
If the patient's status differs from the previous check, the system surfaces a visible alert: status changed, confirm before acting. Nobody gets surprised at claim time.
Append-Only Audit Log
Every check is a timestamped, immutable record. If a claim is ever questioned, the log shows what was known and when. Entries cannot be edited or deleted.
Hospice Workflow
For hospice patients, the system includes a related/unrelated determination workflow so billers can document the clinical rationale before the claim is submitted.
Why This Only Works as a Platform Feature
A standalone Part A/B checker would require re-entering patient data, remembering to run it, and then manually cross-referencing the result with the chart. Built into Medipyxis, the check lives on the same patient record as the chart, the graft usage, and the billing codes — so the workflow is: check, confirm, document, bill. One record. No re-entry.
Same Patient Record
Coverage status, chart, graft usage, and billing codes in one place
Same Audit Trail
The coverage check joins the visit's compliance documentation
Same Billing Workflow
If Part A is detected, the team knows before the claim is built
See the Part A/B check running on a real patient record.
Part A/B Coverage Check — Common Questions
Stop Finding Out at Claim Time
Book a demo and see the Part A/B check live — from the patient billing page, in under a minute.