Before

To verify eligibility, it is necessary to set up the provider's Username and Password with your billing service provider. The patient must have his/her medical plan information on file.



AFTER

Option#1: Search for the existing patient's eligibility.

  • Navigate to the Patients Details screen.
  • Search for the patient, who you wish to review eligibility. 
  • In the Search field, enter the first name, last name, record number, or alternate record number.

           

  • Click on the Insurances tab, located on the right side of the screen. 


  • The Insurances section will be displayed. Once displayed, click on the Eligibility button, located in the center of the section. 

  • It will show medical plan eligibility and pharmacy coverage eligibility. 


  • If you wish to view the patient's medical plan eligibility details, click on the More button located at the top of the screen and then select the Eligibility option.  


  • The following screen will be displayed, with detailed information on the patient's service eligibility. You can select secondary plan eligibility if any.


  • If you wish to view pharmacy coverage eligibility, click on the Pharmacy tab.  
  • Detailed pharmacy eligibility information will be displayed.  

TO SEARCH FOR INSURANCE PLAN ELIGIBILITY

  • Upon entering the eligibility screen, the patient's medical plan coverage will be displayed.  

         

TO SEARCH FOR THE PHARMACY ELIGIBILITY
  • In order to display the pharmacy benefits, click on the Pharmacy tab.

       

Option #2: Eligibility search for patients NON existing

(Only to perform the medical plan eligibility search, this option does not apply to the pharmacy eligibility search).)

  • From the main menu, press the eligibility button. Or, click on the QuickLinks text located at the top of the screen and select the Eligibility option. 
    • Modern Main Menu: Press the Eligibility button.


  • Classic Main Menu: Click on theEligibilty button, located at the top of right side of screen.


Perform the following steps: 
  • Record the patient's first and last name
  • Record the patient's date of birth.
  • Select the patient's gender. 
  • Enter the patient's address. The city field will be automatically filled in as soon as the zip code is entered.
  • Record the patient's medical plan information. 
  • Once all the information has been recorded, press the Services button, located at the top of the screen, or press the Refresh button, located in the center of the screen.


  • The patient's eligibility will be displayed. 



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