Tuesday, October 2, 2018

Online Eligibility


Surely, there are better things to do than verify a patient's insurance eligibility over the telephone, or by logging into and navigating the web pages of an insurance company's website. But, that's where Rexpert's Online Eligibility query comes in!

The Rexpert™ system automates the whole insurance eligibility-checking process for you by communicating with the Change Healthcare clearinghouse, behind the scenes, to determine insurance coverage. The Online Eligibility function saves time in what was formerly a labor-intensive process, allowing for easy verification with just a mouse-click or two.

Unlike most things in life, the process is fairly straightforward. You simply press the green Eligibility button on an Account Payor and within seconds, you will receive a full report. Just be aware that while patient/account online eligibility verification is managed within the Rexpert™ system, the actual eligiblity information is obtained from a third-party website. The information on the report cannot be changed or updated by Rexpert nor can we verify the accuracy of the information contained in the report. The information provided is based on the Payor's name and the interpretation thereof by the third-party and care should be taken that provider names and inputs are accurate as possible.

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The report provides a summary of the patient's insurance coverage, while also providing detailed information about specific types of insurance benefits that may or may not be included in the coverage. For instance, Jill Doe is on her father John Doe's insurance, and Mr. Doe is not sure how much of his deductible is left. You run an Online Eligibility query and a quick read shows Jill has a $1,000 deductible of which $497.84 has been met, leaving $502.16 still remaining.

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On the upper left corner of the report is a column of coverage and benefit categories; clicking on one of these categories will display the corresponding summary for the category selected. For instance, in the example above, if you need to know what the co-pay is for a chiropractic appointment, clicking on the Chiropractic link will bring up the chiropractic benefits in her coverage, where you will readily note the co-payment is $35.00.

Also note the Rexpert logo at the top of the report. The logo can be replaced with your own practice logo if you so desire.
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If you'd like to have your practice use Online Eligibility, contact Client Services via the Feedback button and we'll be happy to discuss the implementation process and costs.