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Understanding Your VOB Results

When a verification finishes, VerifyTx shows the result as one consolidated VOB, even if several requests were made to the payer behind the scenes. This article explains what you'll see and how to read it.

 Coverage status

Every VOB shows one overall coverage status:

  • Active: The payer confirmed the policy is in force for the patient on the as of date.
  • Inactive: The payer confirmed the policy is not in force.
  • Unavailable: We could not get a usable answer, for example because of a payer timeout, a payer rejection, or a response we could not read. Unavailable does not mean the patient has no coverage. Check the member details and try Re-Verify, and contact Support if it keeps happening.

The VOB page tabs

VOB Details

This tab holds the general plan and patient information, such as:

  • Request information: name, date of birth, age, client type, facility, and place of service
  • Coverage information: coverage status, internal reference number, coverage date returned by the payer, plan start and end dates, employer or group name, group number, eligibility date, and any payer notes
  • Plan / product information: plan details when the payer provides them
  • Additional payers: other payers the payer reports, such as Medicare, Medicaid, or another commercial plan
  • Patient / subscriber information: demographics returned by the payer
  • System information: reference IDs and other details helpful when contacting Support

In Network and Out of Network

These tabs show benefits separated by network status. Benefits are grouped by service type, such as Hospital Outpatient or Mental Health. Which service types appear depends on your facility's business type.

Within each service type you may see:

  • Coverage / eligibility
  • Deductible
  • Out-of-pocket
  • Copay
  • Coinsurance
  • Authorization requirements
  • Limitations
  • Payer notes

VOB History

Shows earlier results for the same VOB. See Re-Verifying a VOB and Using VOB History.

Why some sections look incomplete

Payers return benefit information differently, so it is normal for results to vary.

  • Only returned benefits are shown. A service type may display just one item, such as coinsurance, if that is all the payer returned for it.
  • Each service type has its own status. A service type can read Covered, Non-Covered, Inactive, or Unavailable. Non-Covered means the payer answered that the plan is active but does not cover that service. Unavailable means we did not get a usable answer for that service.
  • One service type does not change the overall status. A plan reads Active even if one service type is Non-Covered or Unavailable.
  • Partial results are still complete. If some service types come back and others fail, the VOB finishes. Successful ones fill in normally and the rest show as Unavailable.

If something doesn't match the payer portal

  1. Confirm the name, date of birth, and member ID are correct. See VOB Discrepancy Alerts.
  1. Click Edit and Save and Verify to run it again.
  1. If it still looks different, contact Support and include the reference ID from the VOB's System Information section and what you see in the payer portal.