Before

It is necessary to configure the Username and Password of provider with Clearinghouse, to verify an eligibility. In addition, patient must have the insurance plan registered.



AFTER

Option #1: Search for the existing patients eligibility.

  • Go to the Patients Details screen.
  • Search for patient you wish to verify eligibility. 
  • In the search field, write the name, last name, record number, social security number or phone number.

           

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


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

  • The primary plan eligibility and the pharmacy benefits, will be displayed. 


  • If you wish to verify the eligibility details, click on the More button, located at the right side of screen and then select the Eligibility option.


  • The following screen will be displayed, with the patient's eligibility detailed infor,mation.


  • If you wish to verify the pharmacy eligibility benefits, click on the Pharmacy tab.
  • The pharmacy benefit information will be displayed. 

TO SEARCH FOR INSURANCE PLAN ELIGIBILITY

  • Upon entering the Eligibility screen, the patient's medical cover 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 searches for the Insurance Plan eligibility search, option does not apply for pharmacy eligibility.)

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


  • Classic Main Menu: Click on theEligibilty button, located at the top of right side of screen.
  • Perform the following steps: 
    • Register the patient's name and last name. 
    • Register the patient's date of birth. 
    • Select the patient's gender. 
    • Register the patient's address. The city field will be automatically filled, once the zip code is entered.
    • Register the patient's plan insurance information. 
    • Once all information is registered, click on the Services button, located on the screen toolbar. Or click on the Refresh button, located at the center of the screen. 


  • The patient's eligibility will be displayed. 



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