Revenue cycle
Know what's covered before the first session.
Real-time eligibility on the chart, with behavioral health benefits broken out — deductible, copay, coinsurance, and whether the level of care you're admitting to is covered at all.
Runs at intake and on a schedule. Coverage changes get caught before they become write-offs.
What actually comes back
A 271 response is unreadable. This is what it says.
Payers return eligibility as a machine format nobody at the front desk can parse. Unisona Health reads it and shows the four things that decide whether you can admit this person today.
Coverage moves
Checking once at intake is how a month becomes unbillable.
Plans terminate. Employers change carriers. Someone ages off a parent's policy in week three of a ninety-day episode. Re-verification runs on a schedule so the change surfaces while you can still act on it.
Run from the pre-screening form before anyone books an assessment.
Day 0Re-run and record the benefit snapshot on the chart.
Day 1Automatic re-check across the active census, flagging any change.
OngoingTerminations and plan switches raise an alert to billing and to intake.
As it happensIntake decisions
Knowing residential needs prior authorization before admission is worth more than knowing after.
The most expensive eligibility answer is the one that arrives after the patient is in a bed. Reading the benefit at inquiry means the utilization review conversation starts before the clinical one is finished.
Questions
Common questions.
What behavioral health benefits does the eligibility check return?
Unisona Health reads the payer’s 271 response and shows the fields that decide whether you can admit today: whether behavioral health coverage is active, the deductible and how much is met, the IOP copay, coinsurance after deductible, and whether the level of care you’re admitting to — such as residential — requires prior authorization.
How often is eligibility re-checked?
Four times per episode: at inquiry from the pre-screening form, at admission with the benefit snapshot recorded on the chart, monthly across the active census, and on change — a termination or plan switch raises an alert to billing and intake as it happens.
Why check eligibility more than once?
Plans terminate, employers change carriers, and someone can age off a parent’s policy in week three of a ninety-day episode. Checking only at intake is how a month becomes unbillable, so re-verification runs on a schedule to surface the change while you can still act on it.
Works with
It runs on the same record as the rest of the platform.
Revenue cycle
Prior authorization tracking
Dollars authorized, dollars used, visits remaining, and expiration date — live while the appointment is being scheduled.
Read more →Revenue cycle
Patient balances & pay links
Balances calculated from the remittance, statements the patient can actually read, and a payment link that works from a phone — plus payment plans for the balances that need one.
Read more →Operations
Admissions & intake
An embeddable pre-screening form on your site feeds a lead queue.
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