Integration Enhancement: Additional Plan Display in Eligibility Response Interface

Patient > Insurance > Eligibility

What’s Newnew_symbol-1

  • Introduced a dedicated section labeled “Additional Payer (Pharmacy)” within the eligibility response interface.
  • This section is visible immediately after the subscriber information, ensuring quick recognition of secondary/pharmacy coverage.
  • The data shown includes:
    • Payer Name (e.g., SILVERSCRIPT INSURANCE COMPANY)
    • Address
    • Phone Number
    • Website (if present)
  • The payer is sourced from the NM1*P4 loop in the EDI 271 file and is parsed along with standard plan data.

Purpose & Benefits:

  • Improves provider visibility into non-primary coverage, such as pharmacy benefit managers (PBMs) or secondary plans.
  • Enables better coordination of benefits and billing workflows.
  • Ensures consistency across eligibility response handling for both professional and institutional claims.

Behavior Consistency:

  • This logic is in alignment with how professional eligibility responses are handled, ensuring a uniform user experience across modules.

IEAdditionalPlan