How do VOBs (Verification of Benefits) work?

Verifying patient insurance coverage is a time consuming task Wendi is built to help take on. In this article we discuss both level 1 and level 2 VOBs.

Level 1 VOBs in Wendi determine the basic cost sharing metrics of the patient's insurance plan. In order to run this eligibility verification, Wendi needs the following information:

First and last name
Payer name
Member ID
Birthdate

This information is collected through our standard “Benefits Form,” present in your default Wendi Settings workflow. If you prefer to build your own custom forms for intake, ensure the patient provides the above fields for eligibility check automation to operate as intended. Forms can be embedded onto websites in addition to being included in SMS and chat workflows.

Through either the automated solicitation of patient data using the live chat function or manual creation of patient records on the Wendi dashboard, the system will process the information provided through a basic eligibility check.

Results of these checks report:

Deductible/Remaining
Coinsurance/Copay
Maximum out-of-pocket
Whether the policy is active
Basic subscriber information
Timestamp of when the benefits check is made

In many cases it will also include limitations and exclusions for this coverage category. You can re-run benefits checks with a click of the "Reverify Benefits" button on the patient page at any time.

Wendi will show you a snapshot but we also provide a toggle view to see the exact file as it returned from the clearinghouse for, in some cases, more in-depth information.

The Wendi Level 2 VOB check is an AI VOIP call that will trigger once the Level 1 check is triggered; there is no action you need to take as a provider to start this process.

Once enabled, Wendi will run through a customized audio script that we develop with you during our implementation phase. This allows us to enrich the data set of your patient's eligibility profile according to your practice's workflow.

While it is automated, this AI voice call mimics what an in-house or outsourced human biller used to do manually over the phone, so it is not instant- because there are often hold times with the insurance company and they need to be queued to run during operating hours (i.e We have to connect to a human on the insurance company side).

The results and contents of that automated AI VOIP call with the payer will then be visible in the “Level 2” tab of your dashboard, visible if you click on a patient record.

To get your Level 2 VOB set-up, we will need:

CPT codes for services provided
Insurance payer numbers
Additional questions you would like asked.