VERIFICATIONS feature is enabled.
A verification asks the payer whether a patient’s coverage is active and what it covers, and stores the answer against the patient.
Running one
Create a verification for a patient with their carrier and member ID. VoxHealth sends the eligibility request and files the response: active or not, plan details, and the benefits that came back. The service-type asked for follows your practice’s specialty, set in practice details: dental practices are checked for dental benefits, everyone else for general health benefit coverage. Getting the specialty wrong is a common cause of thin or unhelpful responses.Reading the result
Active with benefits
Active with benefits
What you wanted. Benefits are stored and visible on the patient and in Huddle.
Active, but thin
Active, but thin
Coverage is confirmed, the payer returned little detail. Common, because payers differ enormously in what they send back. Add anything you learn by phone as a manual benefit.
Not found / not active
Not found / not active
Either the member ID or date of birth does not match the payer’s record, or the coverage genuinely is not active. Check the identifiers first. A transposed digit looks exactly like a lapsed policy.
Failed
Failed
The request did not complete: a payer outage, an unsupported payer, or a malformed identifier. Failures are surfaced rather than hidden, so a verification that shows an error genuinely needs re-running.
Manual benefits
Anything you learn from a payer phone call can be recorded on the verification by hand, so the next person to look does not repeat the call.Where it shows up
Verified coverage appears on the patient record and in Huddle, so the morning meeting shows who is arriving with unverified or problem coverage.Related
- Patients
- Remittances: the other end of the same money