Entering insurance eligibility status

The Eligibility icon indicates the patient's insurance eligibility status.

Note: You cannot edit the text in the text field, and the text is disabled for new patients or patients who do not have a Family File record.

·        A blue E on a white background indicates that the patient is eligible for benefits, and the description reads YES.

·        A gray E on a yellow background indicates one of the following:  

·        The patient's eligibility is questionable because of an invalid NPI, missing information, an unsupported payor, a subscriber/insured could not be found, or the patient was not found. The description reads OTHER.

·        The patient's eligibility has not been checked or entered for the past five days.

·        If the Eligibility icon does not appear and the text field is blank, the patient's eligibility has never been checked or entered.

To enter a patient's insurance eligibility details manually

1.   Double-click an appointment for the patient whose insurance eligibility details you want to enter.

The Appointment Information dialog box appears.

2.   Right-click the Eligibility icon, and click Enter Eligibility Status.

The Eligibility Status dialog box appears.

3.   Select a status: Eligible or Other.

4.   Type a short description that explains the selected status.

You may enter a description of up to 100 characters but generally one or two words are sufficient.

5.   Do one of the following:

·        Type the date that the patient's eligibility expires (mm/dd/yyyy)

·        Click the Expiration Date search button.

The Select Date dialog box appears.

·        Scroll to the month you want, click the appropriate date, and then click OK.

6.   In the Note field, type additional details regarding the eligibility status, such as who was contacted, the initials of the staff member who verified the eligibility, and special notes. Click the spell check button to perform a spell check of the note.

7.   Click OK.