The Eligibility icon indicates the patient's status.
Note: You cannot edit the text in the text field, and the text is disabled for new patients or patients who do not have a Family File record.
A green E on a white background (with a small red corner box) indicates that the patient is eligible, and new eligibility data is ready for review and approval to be saved to the coverage tables. (Once data is saved to the coverage tables, the icon changes to a white E on green background.) This icon appears for a patient whose eligibility has never been checked, or for one whose previous eligibility status has expired and the current eligibility request has returned new data.
A white E on a red background indicates that the patient is not eligible but was found successfully.
A white E on an orange background indicates that the patient was not found (hover detail recommends verifying that the patient's name is correct).
A white E on a gray background indicates that a request is in progress. The icon will turn green, red, or orange when a response is received.
Note: The eligibility statuses from payors are not standardized. A payor can use any of over 40 distinct statuses. There is an Eligible status, but all of the other statuses are the result of missing information or an input error. There is not a distinct Not Eligible status.
To view the details of an insurance payor's eligibility response
1. In the Appointment Book, double-click an appointment for the patient whose insurance payor eligibility response you want to view.
The Appointment Information dialog box appears.
2. Right-click the Eligibility icon, and then click View Eligibility Detail in Document Center.
The Eligibility Detail Document appears.
3. Do one of the following:
Click the Print button.
A copy of the report prints.
Click the Add to Patient's Document Center button. (If you are using eSync 2.7 or newer, a copy of the report goes to the Document Center.)
The Add Patient Eligibility Detail to Document Center panel appears.
4. Type any relevant notes, and then click OK to send the report.