Configuring Insurance Eligibility

Admin Config -> Options -> Admin tab

You can add a service to ClinicTracker that automatically checks whether a client has viable insurance coverage. For more information about this module, please contact our support team by clicking on the blue support tab on the right-hand side of this screen. 

Like with all of ClinicTracker integrations, you can configure this module so it works exactly the way you want:

Options

To configure your Insurance Eligibility Verification settings, go to: Admin Config -> Options -> Admin tab. Next to Eligibility Verification, press the Configure button.

Now follow the instructions below:

1. The system will automatically verify coverage for any patient listed on the Scheduler in the number of days you specify. Use this drop-down to select the number of days to check ahead.
2. Select the number of days that the system should retain the eligibility data.
3. If this option is selected, only the specific payor recorded on the scheduled event (or the patient's primary if one is not specifically selected) will be checked. Otherwise, all payors listed on the patient's demographic record will be checked. 
4. Select the services for which you would like to verify coverage.
5. Identify the Requesting Party.
6. The default number of days to scan ahead in the eligibility request.
7. Press Save.

Insurers

The system needs to know how to route your Insurance Eligibility requests. You configure this information by entering a GEDI Payor ID number into each insurance company record in ClinicTracker.

To configure the Insurers go to: Utilities -> Maintenance -> Insurance Input -> Insurance Eligibility Config.

Next, click the TriZetto Payor ID drop-down:

Press F2 on your keyboard to search for the insurance company by name:

You've now entered the payor ID into the TriZetto Payor ID field.

Next, place a checkmark in the 'Enable Verification' box and press the Save button to save your changes.