Eligibility Checks & Clearinghouses

@albanyeye @stephenwaite @KyleNave and others. I brought this project into codebase and have attached a patch for easier testing. Currently I have no plans to back port to 501 unless it is strongly requested. Some points:

  • Some X12 Partner settings have been restored and will populate 270.
    – Sender ID Qualifier (ISA05) and Receiver ID Qualifier (ISA07).
    – ID Number (ETIN) for payer NM108 default is 46 but sometimes PI may be needed.
    – User Logon/User password are for RealTime MIME interfaces currenty Office Ally.
    – Processing format currently doesn’t do anything but will in future.
  • To turn on Office Ally enable in Globals->Connectors.
  • To turn off detailed 271 report downloads after 270 processing Globals-Features->Disable Insurance Eligibility Reports Download
  • The demographics Insurance Eligibility report is very detailed and may require some knowledge of codes. Did best I could without have access to the specs.
  • Eligibility batch is better presented for what patients to request 270s. This is based on whether patient has near time appointments. No appointment, no eligibility request.
  • I have plans to add a realtime request button to insurance Eligibility report tab to get new eligibility status for patients and possible in calendar as well.

I hope this all proves useful and thank you albanyeye and Stephen for your support.
eligibility-patch-master.zip (165.8 KB)

2 Likes