The two terms get used interchangeably because most EHRs show a green checkmark labelled "verified" after an eligibility check. The checkmark means the policy is active. It does not mean the procedure is covered, that no prior authorization is needed, or that the patient's deductible has been applied to this service.
The gap is expensive. Optum's 2024 Revenue Cycle Denials Index, drawn from 124 million hospital claim remits, attributes 24% of denials to registration and eligibility errors and finds 84% of denials potentially avoidable. Many of those are cases where the patient was eligible and the benefits were never checked.
