Eligibility FAQs

Eligibility FAQs

Eligibility FAQs

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.


How can I check Eligibility on a specific Patient when the Eligibility 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.

  1. The Eligibility Payer ID can be entered on the Insurance Management Add/Modify Insurance screen.
  2. This will override the entry in the Insurance Library.

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

    • Related Articles

    • FAQs Overview

      Anesthesia Billing FAQs Charge FAQs Demographic FAQs Eligibility FAQs Encounter/Visit FAQs Encounter by Status FAQs ERA FAQs Form and Superbill FAQs iDology Direct Scanning FAQs Job Scheduler FAQs Patient FAQs Payment FAQs Permission FAQs and ...

    • Patient FAQs

      Patient FAQs Alert/Header How do I remove an Alert or Header? Cases How do I add a Case? Charges How do I post a new Charge? Debit/Credit Cards: How do I add a Debit/Credit Card? Deceased How do I indicate that a Patient is deceased? How do I ...

    • Eligibility History

      Eligibility History can be accessed from multiple places in the System and can be viewed by Patient and by Batch. Eligibility History Report Reports > Patient panel > Eligibility History button. This report can be used to view the Eligibility checks ...

    • Batch Eligibility Overview

      You must have Real-Time Eligibility Verification enabled in your Database to check Eligibility in a batch. Contact Support for more information. Patient Eligibility can be checked in a batch for the Appointments on the Calendar using the Job ...

    • Real-Time Eligibility Verification

      Insurance Eligibility can be checked from various locations in the System. The Eligibility Payer ID and Eligibility Time Frame is setup in the Insurance Library. If you do not use the Eligibility verification for 90 days, the service will be locked. ...