Eligibility Check
Eligibility + LDS® — Two Complementary Platforms, One Smarter Lab Reimbursement Workflow
Eligibility Check verifies active coverage and payer details before the test. LDS® helps identify medical necessity, test relevance, ICD-10/LCD/NCD alignment, and reimbursement risk before claim submission.
1. Verify active coverage
2. Review benefit details
3. Check medical necessity
4. Order the right test
5. Improve reimbursement confidence
Eligibility Platform
Verify Coverage & Benefits Before the Test
Patient
John Doe
Payer
Commercial Payer
Plan
PPO
Copay
$25.00
Coinsurance
0%
Deductible
$400.00
Remaining Deductible
$400.00
Authorization: No · In-network status shown · Service-specific payer notes available
LDS® Platform
Identify Medical Necessity & the Right Test
1,500+ Payer Connections
2,300+ Tests
Lab-Focused Benefit Parsing
Medical Necessity Guidance
ICD-10 / LCD / NCD Support
Web Portal + API Access
Confirm Active Coverage Before Testing
Reduce denied claims and patient responsibility by verifying coverage and benefits upfront.
Surface Reimbursement Risks Before Billing
Align tests with medical necessity and payer policies to reduce audit and recoupment risk.
Guide Appropriate, Billable Test Ordering
Order the right test with ICD-10, LCD/NCD alignment and clinical relevance scores.
Better Together
Why Eligibility Check + LDS® Work Better Together
From active coverage verification to medical-necessity alignment, Eligibility Check and LDS® help laboratories close critical reimbursement gaps before testing and billing.
Eligibility Before the Test
- 1,500+ payer connections
- Confirm active coverage
- Surface copay, deductible, remaining deductible and network status
- Independent / diagnostic lab context
- Instant + batch verification
LDS® at the Order Stage
- 2,300+ tests
- Proprietary scoring algorithm
- Medical necessity guidance
- ICD-10 / LCD / NCD support
- Selection assistance and billable test ordering
Better Together
- Reduce reliance on stale eligibility data
- Align testing with coverage and payer policy
- Identify reimbursement issues earlier
- Improve reimbursement confidence before claim submission
- Support web portal + API workflows
One Lab-First, Integrated Workflow
From Payer Response to Smarter Test Ordering
Receive order
Run eligibility check
Normalize benefits
Run LDS review
Guide test + diagnosis alignment
Submit cleaner, more confident claim
Built for Diagnostic and Independent Laboratories
One lab-first workflow — from payer response to smarter test ordering.
Integrations
Seamlessly Integrates With Your Systems
Eligibility and benefit information is not a guarantee of payment. Benefits and accumulated amounts may change as claims are processed; availability and detail vary by payer and plan.
Ready to Close Reimbursement Gaps Before You Bill?
See how Eligibility Check and LDS® work together to verify coverage, guide test ordering, and improve reimbursement confidence.
Request a Demo