PERMISSION REQUIRED: An administrator must Enroll in Eligibility Requests and Turn On Eligibility Requests to enable this feature for clinic users.
Eligibility Requests allow users in your clinic to contact a patient's insurer and verify that patient's insurance electronically through the system. This can save time by reducing the need to have to call the insurer. When a user sends an Eligibility Request through the system, the insurer will send a PDF back through the system with information about the patient's coverage for services. Eligibility Request results will display in the Eligibility Requests section of the patient chart. After an eligibility request has been returned, clinic staff will need to review the results and document the relevant information in the Verification section of the patient's chart.
There are a few different ways to submit eligibility requests within the system. If you want to submit eligibility requests for multiple patients at the same time, or you want to select patients to submit requests for from a list of unverified patients, you can use the Verification Reminders page. After eligibility requests have been sent, you can View Eligibility Requests and track the status of all requests on the Eligibility Requests tab.
Send Eligibility Requests for Multiple Unverified Patients
- Click the Schedule tab at the top of the screen.
- Click Reminders in the menu in the left.
- Click Verifications.
- Click the Unverified tab.
- Click the Checkboxes next to the patients you are sending eligibility requests for.
- Click the Send Request button.
- Select or Enter the NPI you are sending the requests under in the NPI field. (This will default to the clinic's default Reserve NPI. You can use the drop-down to select a different Reserve NPI, or enter another NPI in the field.)
- Enter the Date that the requests should be effective as of in the Date field. (For example, a date of service.)
- Click the Send Request button.
