Run Insurance Eligibility Verification in Clinical

About

If your Agency has contracted with Trizetto to check client eligibility, you will have access to a Realtime Eligibility field that can be displayed on Forms or Notes so that the client's insurance coverage can be checked prior to providing Services. This is frequently used by non-residential/outpatient facilities so that eligibility can be checked on a per-client basis. The information returned will vary by Payer.

Note: If the Realtime Eligibility field has been added to Clinical Forms, the client has to be admitted to a program first to be able to access it. If it is added to a Note, it can be accessed whether or not the client is admitted.

Run Eligibility for a Specific Client

  1. Navigate to a Form or Note that contains the Realtime Eligibility field.
  2. Search for and select the client.
  3. In the Form or the Note, scroll to the Realtime Eligibility field. This field may be called something different depending on how your Agency named it.
  4. Select a Payer Name from the drop-down menu.
  5. Enter the Subscriber Number.
  6. Select a Provider Name from the drop-down menu.
  7. Select a State from the drop-down menu.
  8. Click the Check Eligibility button.

Note: To clear your selections, click the Clear Eligibility button.