The Eligibility Engine

Automated eligibility: eligibility verification that runs itself.

Commercial and Medicaid checks, automatic change detection, and forward-looking deductible forecasts — working together so your team learns about coverage issues before they become billing problems.

Two engines, one workflow

Real-time commercial.
Unlimited Medicaid.

Cori covers both ends of the eligibility spectrum — checks you need answered instantly, and checks you need run at scale.

Commercial — real time

Single-patient, on-demand benefit checks (X12 270/271) routed through over 3000 payer databases, returning structured results your staff can act on immediately — coverage status, plan details, deductibles, and more.

  • ⚡ Fast request & response
  • 🔌 Multi-payer routing (thousands of payers)
  • 🗂️ Structured results saved to the patient record
♾️

Medicaid — unlimited batch

Batch Medicaid checks, processing your entire Medicaid roster automatically — with no per-check limits and no per-transaction fees standing in the way.

  • 📅 Runs on a recurring schedule, hands-free
  • ♾️ No caps on volume, no per-check charges
  • 🏛️ Built for Colorado Medicaid via HCPF
More on batch verification →
Beyond the check

Cori doesn't just run the check — it tells you what it means

📧

Automatic coverage-change comparison

Every new result — commercial or Medicaid — is automatically compared against the member's prior eligibility check. When something changes (a new plan, a different deductible, a coverage gap), Cori emails the relevant staff a clear, readable summary. No manual comparisons, no missed changes.

📉

Deductible burn-down forecasting

Cori's deductible predictor tracks how a member's remaining deductible moves between checks and projects forward to estimate the date it will reach zero. That gives scheduling and billing teams a heads-up — instead of finding out only after a claim posts differently than expected.

How a check flows through Cori

From roster to insight

One pipeline handles both commercial and Medicaid checks, ending in the same FHIR-native store and the same automated alerts.

Client RosterYour organization
CoriOrchestration
Request sent to PayersOver 3000 payers supported
Payers RespondEligibility result
Compare & ForecastChange detection + deductible projection
Email & ReportsStaff notified automatically
FHIR StoreAuditable, interoperable record
Sample eligibility data sheet

A sample of the structured eligibility data Cori extracts from every check.

Quantify the leak

See your monthly Medicaid leak

Estimate what undetected coverage lapses cost you each month. Nothing is sent anywhere — the math runs in your browser.

$0
estimated revenue at risk per month — $0/year

Assumes a lapsed client continues to be seen for one month before the denial surfaces. Cori flags the lapse the day it happens.

Want to see this running on real data?

We can walk through a live commercial check and a Medicaid batch cycle side by side.