Eligibility can be checked individually, or the Job Scheduler can be used to run a batch from the Appointments on the Calendar.

• Real-Time Eligibility Verification
• Batch Eligibility Using the Job Scheduler

• To verify Eligibility in a batch, you must be utilizing the Appointment Calendar.

You must have Real-Time Eligibility Verification enabled in your Database to check Eligibility in a batch. Contact Support for more information.

Batch Eligibility Best Practice

Set the Eligibility Time-Frame to prevent running Eligibility on Appointments that have already been verified.

• The Eligibility Time-Frame default is Calendar Month.

Jobs Scheduler Eligibility Jobs

Use two Eligibility Jobs to prevent missing last minute Appointment Eligibility checks.

• Job 1: Set one Job to run several days before the Appointments.
• Job 2: Schedule the second job to run the evening before or morning of the scheduled Appointments

• This Job will capture Appointments that were scheduled after the initial run, and Eligibility has not been verified yet.

The Appointments where Eligibility has already been verified in the first Job will not batch again if the Eligibility Time-Frame is set up correctly.

Eligibility Time-Frame

This determines the number of days that the Eligibility Response will remain valid.

• The Batch Eligibility Job will not run a specific Patient until that number of days has been reached.

• This applies to Individual Eligibility checks and to Patients in an Eligibility Batch Job.

• The Eligibility Time-Frame can be set as a default in System Settings and can be overridden on the Insurance in the Insurance Library.

Set the Eligibility Time-Frame Default

1. From Admin on the Left Side Menu, select the System Settings button.
2. On the Category menu, select Scheduling.
3. ELIGTIMEFRAME - ELIGIBILITY TIME FRAME: Select one of the options from the dropdown that the Eligibility Response will be Valid. If the request has been received within the time frame, the Appointment will display a green check mark on the Calendar.

• Time Frame Options

• 7 to 30 Days
• Calendar Month
• (---): Calendar Month (Default)
• Calendar Year

Set up Eligibility Time-Frame on the Payer

Override the System Setting by setting the Eligibility Time-Frame on the Payer.

1. From Libraries on the Left Side Menu, select Insurances.
2. Select the Insurance ID link.

3. Select the Modify link.
4. In the Insurance Settings Panel, set the Eligibility Time-Frame.
5. Select Save [F2].

Eligibility Time-Frame Examples

• Example of Calendar Month

• Eligibility will be checked for the current Calendar Month.

• It will not Verify Eligibility for any Patient that has already been verified in the current month until the next month.

• Example: The Eligibility Time Frame has been set to Calendar Month in System Settings, and Eligibility has already been checked for the current month.

• If Eligibility is re-checked this month, the current Verification Report will be displayed with a banner showing the date it was last checked.
• The most recent Eligibility Verification Status is displayed in the Default Insurance Profile on the Verification Report.

• In the screenshot below, Eligibility was checked on 4/4/25, and the status was Eligible with Exceptions.
• The Eligibility was run again on 4/8/25, but it was verified again because it was in the same month.

• Example of Day Count: Enter a specific number of days for look back. If the days are set at 7, and the Patient has two Appointments during that 7 days, Eligibility will only be verified once.

• Example: The Eligibility Time Frame has been set to 15 Days on the Payer, which overrides the System Setting Default of Calendar Month.

• On the 16th day, the Verify link is used again for an upcoming Appointment.
• The System will perform a new verification because it is past 15 days.

EQ Codes

Service Type Codes (EQ) are used to identify healthcare services and benefits.

• These codes are used when requesting an Eligibility response.

• Each Payer may have different supported Service Types for Eligibility and Benefits.