Taiga runs an eligibility check before every claim is submitted — automatically, as part of the billing workflow. The Eligibility page is where those checks live: use it to review results, or to verify a patient's coverage yourself when you want an answer ahead of a visit.
Checked before every claim, automatically
You don't have to do anything to get this. Before a claim goes out the door, Taiga verifies the patient's coverage is active with the payer being billed. This heads off the most common denial patterns practices deal with before switching to Taiga:
Claims billed against inactive or terminated coverage
Wrong payer — the patient switched plans and the old card is on file
Member ID mismatches that bounce at the payer's front door
Coverage that changed between scheduling and the visit
Each of these normally surfaces weeks later as a rejection or denial and starts a rework cycle. Caught at eligibility, the fix happens before submission — correcting the member ID, billing the right payer, or confirming new insurance with the patient. When an automatic check flags something that needs your team's confirmation, it surfaces on the Queues page.
Running a check yourself
Use the Eligibility page when you want a coverage answer on demand — before an upcoming visit, after a patient reports new insurance, or while sorting out a front-desk question. Nothing needs to be on file first.
Insurer — start typing the name and pick the plan from the list. Gold stars mark automatic clinic favorites based on currently effective contracts. Favorites appear ahead of other loaded matches, but stars do not restrict your choice: you can select an unstarred insurer for an out-of-network check. You can also search by a plan's other name: a match on another name shows it above the official name and payer ID, and selecting it keeps the official name. For example, CHAMPVA finds SPINA BIFIDA - VA HAC (84146). The insurer must support electronic eligibility for the check to succeed.
Date of service and service — defaults to today and general plan coverage. Pick a more specific service, such as office visit or mental health, when you want that benefit category.
Subscriber — the policyholder's first name, last name, and member ID exactly as printed on the card. Date of birth is optional but helps some payers match.
If the patient is covered under someone else's policy, tick The patient is a dependent on this policy and enter the patient's name and date of birth.
Press Check eligibility. The insurer answers in a few seconds.
Reading the result
Status — Active, Inactive, or Unclear when the payer didn't return a conclusive answer.
Plan details — plan name, member ID, group number, plan type, and the coverage dates the payer reports.
Payer messages — anything the insurer sent back about the request, such as a member ID it couldn't find, with the suggested fix.
Benefits — every benefit the payer returned: deductibles, out-of-pocket maximums, copays, coinsurance, and visit limits, each marked in or out of network and individual or family, with the payer's notes.
Eligibility is informational and does not guarantee payment. Press New check to go back to the form; your entries stay filled in so you can correct a member ID or try another date.