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Network Status
Know in-network or out — before the claim is ever filed
Real-time in-network / out-of-network determination on every eligibility request — plan- and payer-specific, including carve-out nuances
Runs on Verification. No second lookup
Network Status runs directly off Verification’s data the moment coverage is confirmed, with no separate lookup. Developers get an API-first integration. RCM and operations teams get a no-code interface to manage the rules themselves
Out-of-network claims get denied twice as often
37%
of out-of-network claims are denied, roughly double the 19% rate for in-network claims
Network status is usually confirmed the hard way: after the claim comes back denied
Manual network lookups cost staff time on every single request
Source: KFF analysis of 2023 ACA marketplace data (CMS), January 2025
In network or out, the moment coverage is confirmed
Network status unconfirmed until the claim is filed — and denied
In-network or out-of-network status returned the moment coverage is confirmed, automatically, on every request
Network rules your team controls
Real-time determination
In-network/out-of-network status on every eligibility request, automatically
No-code rules engine
RCM teams update plan-, TPA-, and MCO-specific rules themselves — no engineering ticket required
Built-in carve-out handling
Native behavioral health TPA and MCO logic (e.g., Carelon BH, Magellan Health)
Runs off Verification data
No separate lookup, no manual double-check
How Rula automated network requests
1,000hrs
Reduction in manual operations work after Rula integrated Discovery, Verification, and Network Status into its intake flow
Built for sensitive data
Security your IT team will ask about, answered before they ask
Network Status
Frequently Asked Questions
Ready to stop finding out about network status after the denial?
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