Real-time eligibility verification, benefits and coverage discovery, and claims infrastructure — delivered as an API-first platform built on HL7, X12 270/271, and HIPAA-compliant data exchange.
Submit X12 270 eligibility inquiries and receive structured 271 responses in seconds across 1,500+ connected payers — no portal logins, no overnight batches.
Locate active coverage when payer or plan details are incomplete, reducing front-desk guesswork and unbilled visits at intake.
Pull office and specialist copays, coinsurance, deductibles, and out-of-pocket maximums directly from the payer response.
Estimate what a patient will owe before the appointment, based on live benefit data rather than static fee schedules.
Flag services and procedures that require prior authorization as part of the eligibility check, before the claim is ever submitted.
Submit claims with AI-assisted review that catches common rejection causes before they reach the payer, improving first-pass clean claim rates.
Upload a CSV and run hundreds of eligibility checks or claim submissions across multiple payers in a single batch.
REST APIs and EHR/EMR integration connect Vanaa RCM to your existing practice management stack, with an architecture designed for SMART on FHIR readiness as payer adoption matures.
Talk to our team about connecting your practice or billing organization to real-time eligibility and claims infrastructure.
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