Point-of-Booking Eligibility API: $1,500 Setup + $0.05 / Check
Sub-second real-time verification of active copays, deductibles, and policy rules at online appointment checkout via HIPAA BAA gateway.
High-deductible health plans (HDHPs) have made patient point-of-service collections critical to practice solvency. When patients arrive without knowing their deductible or having an inactive insurance policy, front desks either face uncomfortable financial arguments or end up writing off uncollectible debt. TravaLabs integrates real-time EDI 270/271 eligibility APIs directly into the online appointment checkout flow. Within 1.8 seconds of entering insurance card details, our system returns active policy status, copay amount, remaining deductible, and coverage rules under full HIPAA BAA compliance.
Key results
- $1,500 — One-Time API Setup
- $0.05 — Per Verification Check
- < 1.8s — Sub-Second Verification Speed
- 99.4% — Payer Adjudication Accuracy
Core capabilities
- Sub-Second Real-Time 270/271 Lookup — Direct connection to over 1,000 commercial and government payers returns active coverage status and policy details in under 1.8 seconds.
- Clear Point-of-Booking Copay Display — Translates messy insurance benefit tables into clear, simple language for patients: "Your Specialist Copay for this visit is $40."
- Remaining Deductible Alerts — Alerts both the patient and the clinic if the annual deductible has not been met, allowing upfront financial counseling before treatment.
- Intelligent Insurance Card Scanner — Mobile-friendly card scanning allows patients to snap a photo of their insurance card for automated OCR extraction of Member ID and Group Number.
Deployment roadmap
- Day 1–5: Gateway Provisioning & Payer Routing Configuration — Provision enterprise API gateway credentials and configure payer routing matrices covering commercial carriers and regional Blue Cross plans.
- Day 6–12: UI / UX Widget Integration — Embed real-time insurance card lookup fields and camera card-scanner into the patient appointment scheduling funnel.
- Day 13–18: Benefit Rules Calibration & Dry Runs — Validate copay and deductible extraction logic against 100 historical practice insurance cards across top 5 payers.
- Day 19–21: Production Go-Live & Staff Briefing — Activate real-time verification in production and brief front-desk staff on interpreting the automated copay dashboard.
Frequently asked questions
Which insurance payers are supported by this API?
Our gateway connects to over 1,000 payers nationwide, including Blue Cross Blue Shield (all state plans), UnitedHealthcare, Aetna, Cigna, Humana, Medicare, and regional commercial plans.
What happens if a payer website is temporarily down or non-responsive?
If a payer fails to respond within 3 seconds, the system gracefully falls back to queuing the verification in the background and flags the front desk to re-verify upon patient arrival.