Eligibility Status Report is used to check the eligibility of a bulk number of patients at a time. In other words, it is also called batch eligibility verification. When the report is generated, it gives eligibility information about the list of patients based on the search criteria. Eligibility status reports can be generated only if the eligibility verification option is activated with the clearinghouse.
The A10 report can be used for two main purposes.
- Running batch eligibility check in one single go. The ‘Check Eligibility’ Button is used for this. This button would check the eligibility for all patients satisfying the search criteria and the eligibility details of the patients are displayed along with user and the date when the eligibility was checked.
- To find the eligibility status. For this, provide appropriate date parameters and other search criteria and click on ‘Search’ to display the eligibility verification details of the filtered patients.
Table 1 provides the filter options provided in the Eligibility Status Report.
|Appt. Date From/To||Provide Start and End dates or select an appropriate date range from the drop-down.|
|Appt. Type||Consultation/Follow Up etc|
|Appt. Status||Checked in/ Checked out/ Canceled/Missed, etc.|
|Appt. Source||Select how the appointment was made Web/Phone/Email/ Walk-in|
|Legal Entity||To search by Legal entity|
|Provider Name||To search by provider|
|Coverage status||Active Coverage, Active: full Risk Capitation, Active: services capitated, inactive, inactive: pending Eligibility Update, etc.|
Image 1 shows a sample search screen.
Select the appropriate search criteria and click on Search button to view the result. Image 2 is a sample eligibility status report.
To verify the eligibility, hit button. If the full eligibility details for a patient need to be reviewed, click on the icon under the view header; a new window with detailed eligibility information will appear as in Image 3.