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Front desk team member walking a patient through check-in on a tablet
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Roles
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FOR OPERATIONS

Keep patients moving. Get insurance requests off your team's plate

Find coverage, verify benefits, confirm network status, and estimate patient costs in the workflows your team already uses. Spend less time chasing payer answers and give staff a clearer next step when a request needs attention

96%
verification accuracy
15M+
eligibility requests a year
95%+
benefits accuracy
8x
ROI within twelve months
What Operations leaders are up against

Insurance requests shouldn't be a full-time job

A failed insurance request becomes another task.
Someone has to correct a member ID, search a payer portal, call for benefits, or ask the patient to start again. Meanwhile, referrals and appointments are waiting

Active coverage is only part of the answer.
Your team still needs to know whether the service is covered, whether the provider is in network, and what the patient may owe. Carve-outs and plan exceptions make those answers harder to get consistently

The work continues after intake.
Coverage changes, unresolved requests pile up, and staff copy results between systems. Operations need a reliable way to recheck patients, review exceptions, and see which manual steps are actually going away

How Sohar helps Operations teams

Fewer requests to chase. Clearer exceptions

01

Find coverage when insurance details are missing

Search for coverage using basic patient demographics at intake or after a failed request. Verify coverage found before using it to guide care

02

Get the benefits that matter for the visit

Give staff copay, coinsurance and deductible details for the service and setting, with visibility into information that needs follow-up

03

Apply network rules consistently

Apply configured network rules that account for plan differences and behavioral health carve-outs. Maintain supported rules without sending every change to engineering

04

Give patients a clearer cost conversation

Estimate patient responsibility using benefits, service details and contracted rates. Help staff explain expected costs, subject to payer data and final claim processing

05

Keep routine work moving and make exceptions visible

Run requests in the dashboard or through an API. Distinguish pending requests, input errors and ineligible responses to direct the right follow-up

06

Catch changes before the next visit

Repeat requests around upcoming visits to identify coverage and benefit changes early enough for staff to act

Relevant solutions for Operations

Start with the work slowing you down

01

Patient intake

Find coverage and verify benefits during registration, or work through a referral batch before scheduling. Give staff a clear path when information is missing

Dashboard
Network Status
Flows
Payers
Payer Status
Analytics
Create Verification
7c41e2a9
J. RIVERA
Summit BlueCare
complete.eligible
Oct 6, 3:44 PM
6b0f13d4
M. OKAFOR
Harbor Health Plan
complete.eligible
Oct 6, 3:44 PM
5e88a0c7
D. LINDQVIST
Summit BlueCare
pending
Oct 6, 3:44 PM
4a19c6f2
S. PATEL
Northfield Mutual
complete.eligible
Oct 6, 3:44 PM
3d2b7e55
A. MORENO
Harbor Health Plan
complete.ineligible
Oct 6, 3:44 PM
2c90f1b8
K. NAKAMURA
Summit BlueCare
complete.eligible
Oct 6, 3:44 PM
1f7a44c3
T. BECKER
Northfield Mutual
complete.eligible
Oct 6, 3:44 PM
02

Ongoing eligibility

Recheck coverage before upcoming visits and review changed or unresolved results

J. RIVERA
complete.eligible
Detail
Benefits
Network
Copay
Coins.
Deductible left
In Network
$30.00
20%
$850.00
Out of Network
–
50%
$2,000.00
Place of service
02 · Telehealth
Resolved in
7.3s
03

Failed request recovery

Use Discovery after an unsuccessful verification, then verify any coverage found before updating the patient record

No card needed
Discovery
Verified
Coverage found
Recovered after a failed request
Payer
Summit BlueCare
Matched from patient details
Member ID
•••• 4821
Network
In-network
Verified and ready to book
04

Patient cost estimates

Use benefit details and your contracted rates to support conversations about expected payment

Shown before booking
Patient estimate
Verified
You owe $30
Therapy visit · In person
Estimate
$30.00
Copay applied, deductible met
Network
In-network
Coinsurance
0%
05

Network decisions

Apply your organization's rules consistently across supported plans and review exceptions with the context needed to act

Applied consistently
Network rules
Verified
By plan
3 plans checked
Summit Gold PPO
In-network
Harbor Select HMO
Out-of-network
Northfield BH
Carve-out
Routed to separate BH plan
Customer stories for Operations

Results from teams like yours

Receptionist helping a patient check in on his phone
Case Study

Rula saved 1,000 hours of manual operations work per week after embedding Sohar's Verification and Network Status into its intake systems. Its published case study also reports a 30% increase in automation compared with its previous provider. Rula's operations team can adjust supported network automation without involving engineering each time. The result is a more consistent intake process with fewer portal lookups and payer calls

Read case study

Frequently asked questions

Can we start before our engineering team has time for an integration?

Yes. Your team can use the dashboard for individual requests and CSV batches. Start with a defined group, such as patients with failed verifications, and review the results before expanding. An API integration can then bring the requests into your existing workflow; it requires coordination with your technical team.

What happens when a request cannot be completed?

The next step depends on the result. Incorrect or missing information may need correction; a pending request may still be waiting on a payer. An ineligible response needs a different review from a technical error. Agree on those paths during setup so patients are not treated as uninsured simply because a request failed. Manual verification support is an optional service, with availability and scope agreed for your account.

Does an active policy mean we can treat the patient in-network?

No. Eligibility, benefits for the service, and network participation are separate questions. Sohar's products help answer each one. Your team supplies the relevant service details and network rules, and decides how to handle missing or conflicting information.

How do we know whether it is saving time?

Start with your current manual review rate and the time staff spend resolving requests. During a pilot, compare automated completion, recovered verifications, unresolved exceptions, and time to a usable result. Review by payer and workflow so aggregate numbers do not hide a recurring problem. Where remittance data is available, work with Sohar to compare benefit results with processed claims and investigate discrepancies.

What does our team need to prepare?

Choose the first workflow and patient group, identify the payers and services involved, and agree on success measures. Set up provider details, payer mapping, and any network rules or contracted rates needed for the products you use. Decide who reviews exceptions, how often to recheck coverage, and where results should appear. Sohar works with operations and technical teams through testing and rollout.

Can we keep a record of what was checked?

Use available batch exports to review results and individual verification PDF exports to retain a record of the response. When a result needs investigation, share its verification ID with Sohar support so the team can trace the request.

Show us where insurance requests are slowing your team down

Bring your intake process, payer mix, and hardest exceptions. We'll help you identify where to start and what to measure