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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.

See what it costs

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. ProbityCare reads it and shows the four things that decide whether you can admit this person today.

271 response · rawAetna
EB*1*IND*MH*HM~
EB*C*IND**2000*1200~
EB*B*IND*96***40~
EB*F*IND*MH***20~
EB*I*IND*RES*****Y~
DTP*291*D8*20260101~
What it meansread at intake
Behavioral health coverageActive
Deductible$1,200 of $2,000
IOP copay$40 per session
Coinsurance after deductible20%
ResidentialPrior auth required
Plan effective01/01/26

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.

At inquiry

Run from the pre-screening form before anyone books an assessment.

Day 0
At admission

Re-run and record the benefit snapshot on the chart.

Day 1
Monthly

Automatic re-check across the active census, flagging any change.

Ongoing
On change

Terminations and plan switches raise an alert to billing and to intake.

As it happens

Intake 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.

4checks per episode

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