For carriers that accept electronic attachments, Canada users can submit an eligibility request.
For Canada users, in an insurance plan, use the Request Electronic Benefits section.
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Setup
To begin sending electronic eligibility requests, the following must be set up first.
- Set the default eligibility clearinghouse in Clearinghouses.
- Ensure the carrier for the patient supports eligibility.
- Check that the patient's Primary Provider is set to a valid CDA provider in Edit Patient Information.
- For the patient, set the Eligibility Excep. Code in the Edit Patient Information: Other Tab. For most patients, use option 4. Cannot be left as option 0.
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Eligibility Process
To request eligibility:
- In the insurance plan, click Request.
- A prompt displays showing the eligibility request was sent successfully.
- Close out the prompt.
- Click History.
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The response displays if the patient is eligible. No additional information (such as benefit details) is available.