Revenue Recovered This Month
$0
TPA to direct billing conversions
TPA Patients Converted
7
to direct billing
Avg Recovery / Patient
$847
over TPA rate
⚠
3 Patients Still on TPA Contracts — Revenue at Risk
TruHearing (2 patients) + NationsBenefits (1 patient) paying below direct insurance rates. Est. $3,500+ recoverable this quarter.
Today's Verifications
14
↑ 3 from yesterday
Avg Verify Time
2.1s
vs 45 min on hold
Prior Auth Alerts
2
⚠ Action needed
AI Confidence Avg
96%
↑ High accuracy
Today's Schedule
8 appts · 2 need attention
9:00 AM
Marcus Webb
BCBS PPO · HA Eval
9:45 AM
Linda Kowalski
Medicare · Diagnostic
10:30 AM
Robert Vasquez
UHC via TruHearing ⚠
11:15 AM
Patricia O'Brien
Cigna PPO · HA Fitting
2:00 PM
Howard Fineman
Aetna PPO · New Patient
Payer Mix
This month · 47 patients
BCBS
28%
13 pts
Medicare
22%
10 pts
UHC
19%
9 pts
Aetna
17%
8 pts
TPA ⚠
14%
7 pts
7 TPA patients = est. $5,929 recoverable if converted to direct billing this quarter.
New Verification
REAL-TIME ELIGIBILITY · AI-POWERED · <3 SECOND RESPONSE
Patient Information
Insurance & Payer
CPT Codes
92557 Audiometry
92587 OAE
92553 Pure Tone
92620 APD Eval
V5261 Hearing Aid
92590 HA Exam
92626 Auditory Fx
Connecting to payer network...
Sending 270 eligibility inquiry...
Receiving 271 response...
AI extracting benefit details...
Generating plain-English summary...
Checking TPA vs direct comparison...
-
-
AI Confidence
Benefit Details
⚡ AI Benefits Summary — Plain English
⚖ TPA vs Direct Insurance — Revenue Impact for Your Clinic
Additional clinic revenue going direct instead of TPA-
Patient Out-of-Pocket Estimate
TPA vs Direct Billing
THE TPA ESCAPE — SEE EXACTLY WHAT YOU ARE LEAVING ON THE TABLE
$5,929
Recoverable Revenue This QuarterBased on 7 active TPA patients. Average recovery of $847/patient. Most patients follow their audiologist — the switch is seamless when you show them their real direct coverage.
Active TPA Patients — Revenue Gap Analysis
Click any patient to see their full profile and verification history
| Patient | TPA | TPA Pays Clinic | Direct Payer | Direct Pays | Revenue Gap | |
|---|---|---|---|---|---|---|
| Robert Vasquez DOB 01/29/1958 | TruHearing | $1,400/pair | UHC Direct | $2,500/pair | +$1,100 | |
| Carol Simmons DOB 08/14/1953 | TruHearing | $1,200/pair | Cigna Direct | $2,000/pair | +$800 | |
| Dennis Park DOB 03/22/1961 | NationsBenefits | $900/pair | BCBS Direct | $2,500/pair | +$1,600 |
Why Dropping TPAs Increases Revenue
01 — The TPA Discount
TPAs like TruHearing and NationsBenefits negotiate heavily discounted rates with clinics — paying $800-$1,400/pair vs $2,000-$2,500 for the same devices billed direct. The TPA keeps the margin.
02 — Patients Follow You
Most patients follow their audiologist regardless of TPA network changes. VerifyAI shows the patient their real insurance benefit — often equal or better than TPA coverage — making the switch seamless.
03 — You Keep 100%
Billing direct means keeping the full insurance allowance. No TPA cut. No device restrictions. No contracted price lists. Full clinical and financial autonomy restored to your clinic.
Today's Schedule
Wednesday, April 1 2026 · 8 Appointments
5 Verified2 Attention1 Pending
8:15 AM
Margaret Hill
Humana PPO · Follow-up
9:00 AM
Marcus Webb
BCBS PPO · HA Evaluation
9:45 AM
Linda Kowalski
Medicare · Diagnostic Only
10:30 AM
Robert Vasquez
UHC via TruHearing ⚠
11:15 AM
Patricia O'Brien
Cigna PPO · HA Fitting
2:00 PM
Howard Fineman
Aetna PPO · New Patient
2:30 PM
Sandra Lee
BCBS PPO · Annual Exam
3:30 PM
Thomas Grant
Medicare Advantage · HA Fitting
Renewal Pipeline
PATIENTS WHOSE HA BENEFIT RESETS SOON — YOUR BUILT-IN SALES PIPELINE
💡
$14,500 in Potential Revenue in the Next 6 Months
5 patients have hearing aid benefits resetting soon. Proactive outreach now converts renewals before patients go elsewhere. Click any patient to view full benefit details and history.
Upcoming HA Benefit Renewals
Sorted by urgency — contact soonest first
MW
Marcus Webb
14 days
PO
Patricia O'Brien
32 days
SL
Sandra Lee
58 days
TG
Thomas Grant
89 days
HF
Howard Fineman
142 days
Market Intelligence
THE BLOOMBERG TERMINAL FOR HEARING CARE — POWERED BY VERIFYAI NETWORK DATA
VerifyAI Network Intelligence — Coming Q3 2026
Every anonymized verification on the VerifyAI network contributes to a real-time intelligence layer. Benchmark your payer rates against regional averages, track TPA allowance drift, identify high-value patient segments, and see denial rate trends before they hurt your revenue cycle. This data layer is what makes VerifyAI defensible — and what creates long-term value for insurers, device manufacturers, and private equity.
NETWORK
Avg BCBS HA Allowance · CT
$2,420
per pair · 36mo cycle · 47 clinics
NETWORK
TPA vs Direct Gap · Region 1
$1,140
avg gap per patient · TruHearing vs UHC direct
NETWORK
Clinics Dropping TPAs · Q1
+34%
YoY increase · Northeast region
PREMIUM
Prior Auth Denial Rate · Aetna
8.2%
for hearing aids · Q1 2026 avg
PREMIUM
Medicare Advantage HA Growth
+22%
YoY plans with hearing benefits
PREMIUM
Avg Clinic Revenue / Patient
$3,840
direct billing vs $2,200 TPA avg
Audit Log
Immutable Verification Record
HIPAA-compliant · timestamped · append-only
2026-04-01 09:14
Verified Marcus Webb (BCBS PPO) · Conf: 97% · Dr. Torres
2026-04-01 09:02
Verified Linda Kowalski (Medicare) · Conf: 99% · Front Desk
2026-04-01 08:47
TPA Flagged Robert Vasquez (TruHearing) · Revenue gap $1,100 identified · Front Desk
2026-04-01 08:31
Auth Alert Patricia O'Brien (Cigna) · Prior auth required · Front Desk
2026-04-01 08:15
Initiated Howard Fineman (Aetna) · Pending response · Front Desk
2026-04-01 08:00
Session Dr. Michael Torres logged in · Valley Hearing Center