Automated Eligibility Verifications with eMEDIX
Verifying a patient’s insurance eligibility before their scheduled visit can be a time-consuming process. However, Medisoft in conjunction with eMedix clearinghouse can automate this process for you. As long as you are using Office Hours to schedule appointments and have basic patient information such as name, date of birth, sex, insurance name, policyholder name, relationship to insured and policy number keyed in the program, Medisoft can be set up to run eligibility on your appointments OVERNIGHT WHILE YOU ARE SLEEPING 1, 2 or 3 days before the appointment date and you can see the results in several ways.
In office hours, you can see on each appointment a flag that tells you eligibility was checked for each patient and a notation of the date eligibility was run last per patient, see below:
Eligibility Results Window
Eligibility Results on eMEDIX Portal
Individual Eligibility Patient Result Page
The actual eligibility report on a patient will vary based on the carrier as the carrier gets to decide what they choose to provide. Eligibility reports can be as short as 2 pages, or as long as 7 pages and unfortunately, there is not a lot of control over changing this. Each section can be expanded for additional information. Please see a sampling of an eligibility report below:
This will require enrollment with government carriers like Medicare, Medicaid, Tricare, before you will be able to do verifications for their members. Commercial carriers will be ready to verify once your Medisoft is configured to do so and carriers updated with eligibility payer numbers which most times are different than payer numbers for claims. It may also be advisable to have an hour of training to go over all the details and information available when you start using the service.