Description

Screen, where the search for the patient's health insurance and pharmacy eligibility is performed. It is recommended as the first screen when receiving new or existing patients.


Access


Through Main Menu

  • Select the 'Patients' button located in the Main Menu.
  • Choose a patient and then click the 'More' button, which is located on the toolbar.
  • Next, choose the Eligibility option.

Through QuickLinks 

  • Click on the 'QuickLinks' text at the top of the Main Menu screen and select the 'Eligibility' option.

Through Appointments 

  • Select the 'Appointments' button found in the Main Menu.
  • Once on the Appointments screen, click the "More" button located at the top of the screen.
  • Next, choose the Eligibility option.


Sections


Buttons

  • History: Allows to visualize the history of the selected patient's eligibilities.
  • Refresh Services: When pressed, it will perform a search for the patient's medical plan eligibility.
  • Refresh Pharmacy: When pressed, it will perform the patient's pharmacy eligibility search.  
  • Print: When pressed, the eligibility report will be displayed for printing. 
  • Close: Allows to close screen. 
  • Reset: Clear all entries to begin new search.
  • Previous: Returns to previous screen
  • Primary / Secondary: Select the plan to check for eligibility. 
  • Patient Information: The patient's information will be displayed, as registered in EHRez. (It will only be displayed if the screen is accessed from “Patient Details, ‘Appointment’, ‘Billing’ and ‘Medication History’)
    • Note: If the patient bar is not displayed, it means that the user can verify the eligibility of any patient by simply selecting the company, entering the contract number and group number of that patient.

Tabs: 

  • Services: In this area, the information related to the patient's health insurance eligibility will be displayed. In the tab, the name of the insurer will be displayed. The patient's demographic information as it appears on the plan, either primary and/or secondary. Also, it will display the plan's benefit details information. You must select “Primary Insurance” or “Secondary Insurance” in the field at the top of the medical plan name if the patient has a secondary plan. If the patient does not have a secondary plan, the field will be disabled.  

** For security, the information of cover number, group number, patient name, gender, etc. was hidden, since this example was made in a production environment **


  • Pharmacy: In this section, the pharmacy eligibility information will be displayed.

** For security, the information of cover number, group number, patient name, gender, etc. was hidden, since this example was made in a production environment **


  • Coverage Information: Displays the coverage information results. The last column displays the status.
  • All Pharmacy Coverage Types: Coverage details: Retail, Mail, Specialty or Long Term Care.
  • Subscriber Information: Subscriber demographics.
  • Note: Displays information relevant to the eligibility verification.



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