← Insurance Verification, AnsweredHow accurate can a pre-visit patient estimate be?
With CPT-level benefits verified close to the visit and the provider's actual fee schedule applied, 90–95% of estimates match the final EOB within tolerance. The remaining gap comes from accumulators moving before the date of service, services added during the visit, and payer rules that only apply at adjudication. Veribrance's 90–95% figure is estimate accuracy against the EOB.
Accuracy is mostly a function of inputs. An estimate built from plan-level eligibility data cannot be reliable, because it does not know how this procedure is covered. An estimate built without the fee schedule has nothing to apply the percentages to. The practices with the best estimate accuracy are not the ones with the cleverest software; they are the ones whose software has the right inputs.
Last reviewed October 8, 2026
