Integration Enhancement: Additional Plan Display in Eligibility Response Interface
What’s New
- 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.
