|
<< Click to Display Table of Contents >> Checking Eligibility |
  
|
|
<< Click to Display Table of Contents >> Checking Eligibility |
|
Once all configurations have been completed, select Check Eligibility within the patient's expanded demographics to launch the Check Eligibility screen. Keep in mind, this option will only be enabled if there is a visit AND insurance claim linked to the appointment.
Check Eligibility
Once the Check Eligibility screen displays, the following options may be addressed:
•Eligibility Payer ID: This drop-down will automatically display the TruBridge RCM payer identifier in the Insurance Companies table, if present. If a Payer ID does not display, select the drop-down to select the appropriate Payer ID.
NOTE: The Payer ID drop-down may be selected to override any automated selection in the event a different value is needed.
Service Information
•Service Start/End Date: These fields will default to the date of the appointment.
•Service Type Codes: This drop-down will default to the values specified in the Configurations screen; however, this may be modified by selecting or deselecting various service type codes.
•HCPCS: Up to five procedure codes may be entered in this field. This is a free text field as there is no search option.
Subscriber Information
The information in this section pulls from the claim coverage in TruBridge EHR. The information in these fields may be edited and any changes will copy back to TruBridge EHR.
Dependent Information
The information in this section will automatically populate when applicable and may also be edited.
Once all information has been addressed, select Submit to start the eligibility check. If all was successful and a co-payment has been identified, the Co-Payment Information screen will display.
Co-Payment Information
The Co-Payment Information screen will allow a co-payment that is due to be selected based off the service being provided. Hovering over the text in the Service Type column may display additional information received from the payer to aid in identifying the service(s) covered.
NOTE: Hover information will only display if it is included in the 271 response from the payer.
Select the checkbox next to the appropriate co-payment amount and select Save. If a co-payment is not due based off the services provided, such as a wellness exam, then a zero-dollar ($0.00) option is available. The selected co-pay will then display in the Insurance column on the Scheduled Appointments tab as well as in the Insurance information section of the patient's expanded demographics.
If a co-payment amount cannot be determined, select OK to proceed without selection.
In the event an erroneous co-payment amount was selected, or one was not selected because research was needed prior to selection, the co-payment amount may be selected by re-launching the Check Eligibility screen and then selecting the Verification History tab.