Coverage confirmed before care is scheduled
Saga automates insurance eligibility and benefits verification. It identifies the correct payer and plan from the referral, card, or chart, runs a real-time X12 270/271 eligibility check, records coverage and benefits to the EHR, and re-verifies before each visit, so staff don’t discover a lapsed plan at check-in.
Built for → Behavioral health · Orthopedics & ASCs · Radiology & imaging · Infusion
Coverage problems surface too late.
The wrong payer or plan, out-of-date coverage, or a change between referral and visit all turn into denials, rescheduled appointments, and rework that lands on the front desk.
How Saga verifies eligibility
Identifies the payer and plan
Saga selects the correct payer and plan from the referral, insurance card, or chart.
Runs a real-time check
Saga sends an X12 270 eligibility inquiry and reads the payer’s 271 response for coverage status and benefits.
Records benefits to the chart
Coverage status, copay, and deductible details are written to the EHR where staff already work.
Flags problems
Inactive coverage, out-of-network providers, and missing insurance cards are flagged for review instead of discovered at check-in.
Re-verifies before each visit
Saga checks coverage again ahead of every scheduled visit to catch changes early.
What Saga covers
- Payer and plan selection from referrals, cards, and the chart
- Real-time X12 270/271 eligibility checks
- Copay, deductible, and coverage status recorded to the EHR
- Out-of-network and inactive-coverage flags
- Requests for missing insurance cards
- Re-verification before every visit
Fewer hours on paperwork. More capacity for patients.
Eligibility verification questions
What is an X12 270/271 eligibility check?
A 270 is the standard electronic eligibility inquiry sent to a health plan, and the 271 is the plan’s response with coverage status and benefits. Saga runs these checks in real time and records the results to the EHR.
When does Saga re-verify coverage?
Saga re-verifies eligibility before each scheduled visit, so coverage changes are caught before the patient arrives.
What happens if a patient’s insurance card is missing?
Saga flags the missing card and requests it. Each practice configures whom Saga contacts and how.
Does Saga work with my EHR?
Saga works inside Epic, Cerner, athenahealth, eClinicalWorks, MedENT, and other EHRs. It uses a computer-use agent that operates the EHR the way a staff member would, so no API integration or IT project is required.
What results do practices see?
In early multi-site deployments, practices saw 94% less manual back-office work and a 48% increase in labor capacity. Results depend on volume and workflow, so Saga models expected figures against each practice’s own volumes during onboarding.
Comparing options? See how Saga compares with fax OCR, RPA, and outsourced intake →
Confirm coverage before care.
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