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.
Every check is tailored to your specialty’s unique needs:
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Status Is the patient’s insurance active? |
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Financials Deductibles, co-pays, and out-of-pocket limits |
Specialty Limits Multi-phase (Ortho) or vision-specific (Optometry) coverage |
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.
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Verification moves through three stages of depth: each one adding a layer of review and detail.
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STAGE 1 Basic Automated check performed via EDI. Standard eligibility data with limited benefit breakdowns. Up to 40 preset CDT codes |
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STAGE 2 Standard Advanced EDI layer plus a second review by Adit’s RCM team, covering deductibles, co-pays, and plan rules. Up to 20 CDT codes |
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STAGE 3 Extensive Advanced The fullest review: co-insurance, out-of-pocket maximums, and coverage limitations, code by code. Up to 40 CDT codes |
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NEW · IV26
Upgrade one appointment at a time. Stay on Basic and pay only for the appointments you choose to upgrade to Advanced. See “Adit’s New IV26 Module” in the FAQs below for details. |
RCM stands for Revenue Cycle Management. At Adit, we currently focus on the Insurance Verification step of that cycle.
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.
A member of our team will guide you through the setup process. During configuration, you will define:
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.
Basic Eligibility Verification
Basic Verification is an automated eligibility check performed via EDI. It returns the standard eligibility information available through the payer’s EDI response, with limited benefit breakdowns or detailed code-level analysis.
Advanced Eligibility Verification
Advanced Verification provides a comprehensive eligibility and benefits check. The first layer is performed via EDI, and a second layer of verification is completed by Adit’s RCM team. It includes detailed benefit information such as deductibles, out-of-pocket maximums, co-insurance, co-payments, coverage limitations, and plan-specific rules.
Advanced Verification is further categorized as:
Adit’s new Insurance Verification (IV26) module gives you the flexibility to upgrade individual appointments to Advanced. In an ideal scenario, you can be a subscriber to our Basic plan and get your appointments verified 72 hours before the appointment date, while upgrading one-off appointments to the paid Advanced tier for detailed verification. You just pay for that appointment.
Adit’s team will manage the majority of insurance verifications on your behalf. Action is required from your side only when 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, we can also send reminder notifications to your registered email address prompting you to update the missing information and reinitiate the verification in a timely manner.
To update the treatment codes used for insurance verification, please contact our support team by emailing support@adit.com. Your request will be automatically logged as a ticket in our ticketing system and routed to the appropriate team for review and action.
Since insurance verification is offered across multiple tiers, including Basic, Advanced (Standard), and Advanced (Extensive), the treatment codes selected may impact your verification tier and pricing.
For more information on how treatment codes align with each tier and how pricing may change based on your selections, refer to our Guide to Insurance Verification Charges.
Yes. The patient file can be updated in two ways:
You may choose to enable either option, or both, through your preferences in the RCM module.
You can easily monitor the status of all insurance verifications from a single, centralized view. When you navigate to the RCM module within the Adit platform, you will be directed automatically to the Verifications page.
Review the Verification Status column for color-coded status indicators, and refer to the Actions column for Verification Forms or the History of Verification.
For a detailed explanation of each verification status, refer to our article: How To: Check the Status of an Insurance Verification.
Read our Guide to Insurance Verification Charges to learn more!
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How To: Set Up Insurance Verification How To: Check the Status of an Insurance Verification Guide to Insurance Verification Charges