Insurance Verification
Confirming coverage before you need care
Verifying that providers accept your insurance and services are covered
Why does insurance verification matter?
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Out-of-network surprises are among the most common causes of unexpected healthcare bills. Insurance verification confirms that providers are in-network and services are covered before care occurs—preventing expensive surprises.
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See where your benefit plan is leaking
Find out what gaps exist — and what you can do without changing your plan.
We'll show you where money is leaking, risks are growing, and what you can fix within your current structure. No pressure to change brokers, carriers, or benefit design. Just clarity.
- Gap analysis based on your actual plan structure
- Clear findings you can share with your broker
- Recommendations that layer on — no disruption required
Network Verification
We verify that providers are actually in your insurance network. Directories are often inaccurate, so direct verification matters.
Coverage Confirmation
Beyond network status, we confirm that planned services are covered under your plan—identifying any exclusions or limitations.
Pre-Authorization Check
We identify whether planned services require prior authorization and coordinate the authorization process if needed.
Benefit Application
We explain how your benefits will apply to planned services—what portion insurance covers and what you'll pay.
What is Insurance Verification?
Insurance Verification confirms that your insurance will cover planned healthcare services before you receive care.
This sounds simple, but insurance coverage is surprisingly complex. A provider might be in-network but not for your specific plan. A service might be covered generally but excluded in certain circumstances. Prior authorization might be required but wasn't obtained.
Verification prevents these surprises by confirming coverage details before services are rendered.
Why Do Coverage Surprises Happen?
Most employers renew their health plans year after year without questioning the underlying assumptions. Brokers present options, carriers set rates, and leadership approves budgets based on incomplete information.
The result? Companies overpay for benefits employees don't use while missing coverage gaps that create real risk. They accept premium increases as inevitable rather than addressable. They lack visibility into where their money actually goes.
A Healthcare Risk Assessment changes that. It gives you the data and insight to make informed decisions, negotiate from a position of strength, and take control of one of your largest operating expenses.
How It Works
Insurance verification confirms coverage details before care occurs.
Verification Request
Employee identifies planned care and requests verification—confirming network status and coverage for specific providers and services.
Direct Verification
We verify directly with insurance and providers—not just checking directories, but confirming current network status and coverage.
Coverage Analysis
We analyze coverage details—what's covered, what limitations apply, what prior authorization is needed, and what the employee will pay.
Confirmation
We provide verified coverage information so employees proceed with confidence or seek alternatives if coverage isn't what they expected.
When Should Employees Request Verification?
Employees should request verification before:
• Seeing a new provider for the first time
• Scheduling procedures at any facility
• Getting care from providers they haven't verified recently
• Receiving services that might have coverage limitations
• Any planned care where coverage uncertainty exists
Where Does Insurance Verification Apply?
Verification applies to any planned healthcare service:
• Hospital services
• Outpatient procedures
• Specialist visits
• Imaging and lab services
• Therapy and rehabilitation
• Any covered healthcare service
Who Benefits from Insurance Verification?
All employees benefit from coverage verification:
• Those seeing new providers
• Anyone with coverage they don't fully understand
• Employees planning significant procedures
• Those who've experienced coverage surprises before
• Anyone who wants to avoid unexpected bills
See What Our Customers Are Saying
"What could have been data driven, was soon a conversation. Over 3 years with the best coaches, listeners, advisors you could ask for. If Monique didn't have an answer readily, she would note it, research it, and then update you on the answer. Always a positive meeting. Highly recommend!"
— Sue D.
“Our Medical Insurance Premiums were Out of Control! Thanks to Weltrio and their amazing team of healthcare experts, Weltrio is my single most-profitable cost center!”
— Cayuse CEO
Everything You Need to Know
At Weltrio, we are a medically trained team that works with HR and benefits partners at companies of all sizes to improve healthcare quality, reduce risk exposure, and optimize costs. We work within your existing plan structure—providing employers with clarity, trust, and transparency at every step. Whether you're upgrading your benefits plan or building from scratch, we've got you covered.
Is this the same as telemedicine?
No. Clinical support provides guidance and triage, not diagnosis or treatment. We help employees decide when and where to seek care.How many nurses will be assigned to our company?
Assignment depends on your company size and typical utilization. Smaller companies may share a primary nurse with backup coverage. Larger organizations get dedicated teams. Either way, employees experience consistent relationships with clinical professionals who know them.Who answers calls in the middle of the night?
Board-certified nurses from your Weltrio clinical team. We staff night shifts with experienced nurses who have full access to your company's benefits information and employee interaction history. It's not an outsourced answering service.What protocols do nurses use for triage?
Our nurses use evidence-based clinical decision support protocols developed from emergency medicine and primary care best practices. These protocols are regularly updated based on current medical guidelines and are customized for telephone/virtual assessment settings.How much does an unnecessary ER visit actually cost?
Average ER visits cost $2,200 or more—even for minor issues. Add lab work, imaging, or specialist consultation and costs climb quickly. The same conditions treated at urgent care typically cost $150-300, and telehealth visits run $50-75.
