Insurance & Eligibility · Eligibility

Running Eligibility #

Run eligibility after confirming the patient’s coverage information so the request is sent with the best available identifying data.

What to do #

1. Open the correct patient/case or approved eligibility workflow.
2. Confirm payer, member ID, subscriber, relationship, and date of birth.
3. Submit the eligibility request using your practice’s configured process.
4. Wait for and review the actual response rather than assuming success from the request alone.
5. Correct verified data problems and rerun when appropriate.

Verify before you finish #

• The request used the correct payer.
• Patient/subscriber identifiers were checked first.
• The returned response is retained or reviewed according to practice procedure.