Eligibility Access for Inactive or Out-of-Date Insurance Plans
Patient > Demographics > Insurance
What’s New?
With this enhancement, users can now initiate eligibility inquiries and access eligibility history regardless of the insurance plan’s active status or effective date range. The system processes requests even when the plan is inactive or the date of service falls outside its coverage period.
How This Benefits You
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Audit Support – Access historical eligibility data without modifying old records.
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Improved Claim Management – Easily investigate denials related to prior coverage.
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Seamless Workflow – Perform eligibility checks using the same process for both active and inactive plans.
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Time-Saving – Eliminates the need to reactivate outdated plans for eligibility lookups.
How It Works:
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From the patient chart or billing module, initiate an eligibility inquiry or open eligibility history.
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The system no longer blocks access based on insurance plan status or effective dates.
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Eligibility details are returned even for inactive plans or those outside the date of service.
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This ensures full visibility into prior coverage without manual workarounds.
