Source: https://ensurecare.ai/modules/eligibility-reconciliation

> EnsureCare reconciles every registration with the payer’s eligibility response, advances clear matches, and holds each mismatch for a person before billing.

Revenue cycle

# Every registration checked before it reaches billing.

EnsureCare reconciles every registration with the payer’s eligibility response, advances clear matches on its own, and holds each mismatch for the right person to fix before billing.

[Book a demo](https://ensurecare.ai/book-demo) See how it works

- **69%** of Medicaid unwinding disenrollments were for procedural reasons, not ineligibility. KFF
- **19%** of in-network marketplace claims were denied. KFF, 2024

Where it stalls

## Coverage changes quietly. The claim finds out last.

Coverage can break at many points between registration and the claim, including these three.

1. 01. **Renewal lapsed** A renewal lapses on paperwork, and registration still shows the old plan. **Coverage ended**
2. 02. **Details do not match** The payer ID, plan type, or member details on file do not match the payer’s eligibility response. **Eligibility denial risk**
3. 03. **Found at the claim** The mismatch surfaces as a denial, then rework or a surprise bill. **Rework**

How it works

## From coverage gap to resolved.

Registration, coverage, and member details change between visits. When they no longer match what the payer has, the claim is usually the first place anyone finds out.

**Care Adherence Intelligence & Recovery Platform** **CAIR Platform**

[See it on your registrations](https://ensurecare.ai/book-demo) [Explore the platform](https://ensurecare.ai/platform)

What makes it different

## Built to finish the work.

- **Upstream of the denial** A mismatch fixed before billing does not become a denial, rework, or a surprise bill.
- **People fix the exceptions** Clear matches advance on their own. Anything uncertain goes to a person, and confirmed mismatches stay blocked until fixed.
- **An audit trail by default** Every match, routing decision, and fix is recorded, so you can show why each record was released.

Measured from day one

## Results you can see and report.

Every action is logged, so impact is measured against your own baseline.

- Eligibility denials
- Records validated automatically
- Exceptions fixed before billing
- Rework hours

Built for

- [FQHCs & CHCs](https://ensurecare.ai/customers/fqhcs-chcs)
- [Health Systems](https://ensurecare.ai/customers/health-systems)
- [Rural Care](https://ensurecare.ai/customers/rural-care)
- [Ambulatory Surgery Centers](https://ensurecare.ai/customers/ambulatory-surgery-centers)

Pairs well with

- [Prior auth & denials](https://ensurecare.ai/modules/denials-prevention)

Integrates with your existing stack

Epic Oracle Health athenahealth MEDITECH eClinicalWorks Twilio

## Bring us your coverage gaps. Let’s fix them before billing.

Show us where eligibility breaks down. In a 30-minute walkthrough, we will show how EnsureCare reconciles every record with the payer and holds each mismatch until it is fixed.

EnsureCare

[Book a demo](https://ensurecare.ai/book-demo)

[Run your ROI numbers](https://ensurecare.ai/roi)