Eligibility FAQs

Eligibility FAQs

Eligibility Payer ID

How can I check Eligibility on a specific Patient when the Eligibility Payer ID is different than the one in the System?

Payer ID is different than the one in the System

Scenario: The Claims Payer ID is different than the Eligibility Payer ID, and the Eligibility Payer ID field is blank or incorrect in the Insurance Library.

  • The Eligibility Payer ID can be entered on the Insurance Management Add/Modify Insurance screen.

  • This will override the entry in the Insurance Library.


Why is my Eligibility Verify link grayed out?

  • If the Verify button is gray, there is a reason that Eligibility could not be checked.

    • Hover over the Verify button to see the reason.

      • Example: "This payer may not participate in electronic eligibility or the Eligibility Payer ID is missing or incorrect on the Insurance Library record.


    System Message

    What should I do if I get a message stating that Eligibility has not been used in 90 days?

    System Message: Eligibility has not been used in 90 days