Guide to Adit’s Multi-Specialty Revenue Cycle Management (RCM)
Adit’s Revenue Cycle Management (RCM) – Insurance Verification solution enables healthcare practices to automate and standardize insurance eligibility checks. This helps reduce claim denials, protect revenue, and streamline front-office operations.
Unlike manual workflows or basic EDI-only tools, Adit’s RCM combines automated eligibility verification with optional manual verification, delivered through clearly defined tiers aligned to clinical complexity and cost transparency.
Designed as a cross-specialty solution for Dental, Orthodontic, Optometry, and Chiropractic practices, Adit’s Insurance Verification eliminates the operational burden of manual carrier calls while improving accuracy and consistency.
By integrating real-time automated verification with professionally managed manual verification, Adit delivers a scalable, enterprise-ready solution for practices of all sizes—from single-location clinics to large, multi-specialty DSOs.
Insurance Verification Overview
Adit’s Insurance Verification service confirms patient coverage details in real time, tailored to your specialty’s unique needs:
- Status: Confirms whether the patient’s insurance is active
- Financials: Remaining deductibles, co-pays, and out-of-pocket limits
- Specialty Limits: Multi-phase treatment coverage (Orthodontics) or vision-specific allowances (Optometry)
- Benefit Dates: Plan effective dates and renewal cycles
We support both Basic and Advanced eligibility checks and can retrieve procedure-level benefit details for enhanced accuracy.
💡 Best Practice: Verify insurance eligibility 48–72 hours before every appointment. Insurance details can change at any time—early verification reduces claim denials and billing surprises.
FAQs
RCM stands for Revenue Cycle Management. At Adit, we currently focus on the Insurance Verification step of that cycle.
A member of our team will walk you through the setup process, but here are some of the settings you will configure:
- How far ahead of an appointment to trigger the verification
- How often to re-verify a patient
- If you want to attach a PDF or a note with the verification results to the patient’s file
- Which treatment codes to check when doing an Advanced verification and a Basic verification
- If we should verify new patients, existing patients, or both
- If we can contact your patients to request additional insurance information
- All of the insurances you accept and your logins to their online portals
Advanced Eligibility Verification is the initial check done on a patient for their first visit in a calendar year or their first visit after changing insurance. Basic Eligibility Verification is a simplified re-check done for that patient for subsequent visits on the same insurance in the same calendar year where they have already had an Advanced verification. For more information, please see our article on Basic vs. Advanced Eligibility Verification.
Most insurance providers today have online portals, and you must provide your practice login to the provider portal if it exists. If you accept an insurance that does not have a provider portal, Adit will still attempt to verify that patient but may do so by phone or other means.
Let your Adit support team know! We will evaluate that insurance and add it to our master list as long as it is a legitimate insurance company.
You’ll need to make sure you keep your provider portal logins up-to-date in our system to ensure an uninterrupted verification process. If your login for an insurance company’s provider portal changes, you can easily update it so that our team can continue verifying patients with that insurance.
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Navigate to the RCM module.
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Click Preferences in the top navigation menu.
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Select Connect Insurances.
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Locate the desired insurance company in the list.
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Enter your login for the desired insurance portal:
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If you have not entered your login for that portal yet: click the Add button, enter your login, and save.
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If you need to edit the existing login, scroll to the right and click the Edit pencil icon, update your login, and save.
Note: If Adit attempts a verification and is unable to access the provider portal because your login is incorrect or invalid, the verification will be placed On Hold.
Adit’s team will handle the majority of your verifications; you will only need to take action on verifications that are Rejected, On Hold, or Failed. You can also verify a patient yourself if you choose to. To learn more about actions you may need to take, please see our article When do I need to take action on an insurance verification?
You can easily change which treatment codes are verified in either type of eligibility verification. Simply go to the RCM module, click on Preferences in the top navigation menu, then select Verification Settings and scroll down to the section for Advanced Eligibility Verification or Basic Eligibility Verification to modify the treatment codes we verify for either type of verification.
To add a treatment code, select the checkbox next to it in the left panel, and the code will automatically move to the right panel.
To remove a treatment code, click the delete icon next to it in the right panel, and the code will move back to the left panel.
When you have finished making your changes, click the Save button below the treatment code panels.
Yes! Patients that you verify yourself will show a status of Verified followed by the initials of the user who submitted the verification in the Adit platform. If you verify a patient yourself and are unable to complete it, you can also mark a verification as Failed, which will also display with the initials of the user who submitted the failed verification. For more information, please see How To: Manually Verify a Patient’s Insurance.
Yes! We can update the patient file in two ways: adding a note, and attaching a PDF.
You can choose to do either or both of these in your preferences in the RCM module. You can also specify the format of the note that is added to the patient file.
Easily check the status of all of your insurance verifications in one place! When you navigate to the RCM module in your Adit platform, it will automatically bring you to the Verifications page. Check the Verification Status column for a color-coded status, and see any pertinent notes in the Details column. For more information about Verification Statuses, please see our article How To: Check the Status of an Insurance Verification.
How do I sign up for Adit’s Insurance Verification service?
Adit’s Insurance Verification is part of our Revenue Cycle Management (RCM) offerings. To get started, please contact our Upgrades team, who will assist you with enrollment and next steps.
How do I set up Adit’s Insurance Verification module?
A member of our team will guide you through the setup process. During configuration, you will define:
- The lead time before an appointment when insurance verification should trigger
- Whether verification results should be attached as a PDF, a note, or both
- The treatment codes to be validated for Basic and Advanced verifications
Our team may contact your practice to request additional insurance information, if required.
For step-by-step instructions, refer to our article: How To: Set Up Insurance Verification.
What is the difference between Basic and Advanced Eligibility Verification?
Basic Eligibility Verification
Basic Verification is an automated eligibility check performed via EDI. It returns standard eligibility data available through the payer’s response, with limited benefit breakdowns.
- Eligibility and benefits validation for up to 20 preset CDT codes
Advanced Eligibility Verification
Advanced Verification provides a comprehensive eligibility and benefits review, typically used at the start of a new insurance or calendar year.
- Deductibles and out-of-pocket maximums
- Co-insurance and co-payments
- Coverage limitations and plan-specific rules
Advanced Verification is available in two tiers:
- Standard Advanced: Up to 20 CDT codes
- Extensive Advanced: Up to 40 CDT codes
Adit’s new IV26 Insurance Verification module allows you to upgrade individual appointments to Advanced verification on demand. You can remain on a Basic subscription while selectively upgrading one-off appointments and paying only for those enhanced verifications.
When do I need to take action on an Insurance Verification?
Adit manages most insurance verifications on your behalf. Action is required only if a verification fails due to missing or incomplete insurance or demographic information.
In such cases, update the required details in the Adit App so the verification can be retriggered before the patient’s appointment.
If enabled, reminder notifications can be sent to your registered email address to prompt timely updates.
How do I change which treatment codes are being verified?
To update treatment codes, contact our support team at
support@adit.com. Your request will be logged as a ticket and routed to the appropriate team.
Since verification tiers (Basic, Advanced Standard, Advanced Extensive) depend on the number of treatment codes, changes may impact pricing.
For details, refer to our article: Verification Tiers and Pricing.
Will you update the patient file in my PMS/EHR?
Yes. Verification results can be added to the patient file in two ways:
- As a note
- As an attached PDF
You can enable either option—or both—through your preferences in the RCM module.
How do I check the status of an insurance verification?
Navigate to the RCM module in the Adit platform. You will be directed to the Verifications page, which provides a centralized view of all verification requests.
Use the Verification Status column for color-coded indicators and the Actions column to view forms or verification history.
For status definitions, refer to: How To: Check the Status of an Insurance Verification.
How am I billed for Insurance Verifications?
Refer to our Guide to Insurance Verification Charges for a detailed explanation of billing and pricing.