How to Check Eligibility In EHR

Verifying a patient's insurance eligibility is a critical step in ensuring smooth billing and reimbursement processes. Follow these steps to check eligibility in the EHR:

There are two ways to check eligibility in EHR

• Through Patient Encounter

• Through Patient Profile

Steps to Check Eligibility in EMR:

Through Patient Encounter

Step 1: Access the Consults Tab

• From the main dashboard, click on "Consults.”

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Step 2: In the Consults Tab:

• Search and select the consult / encounter.

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Step 3: Select “Patient Info” and then click on “Insurance” to access the insurance information.

• Before proceeding, ensure that the billing provider is selected.

   

Step 4: Click the “Search Icon” next to the Insurance Name field.

Step 5: From the insurance list, search for and select the appropriate billing provider.

Step 6: Save the billing provider by clicking “Save”.

Step 7: Save the updated insurance details by clicking “Save” again.

Step 8: Select “Check Eligibility” to view the insurance eligibility information.

• The saved insurance details will automatically populate here for review.

Step 9: Click “Check Eligibility” to initiate the eligibility verification process.

Step 10: If required, you can print the eligibility results by clicking “Print Result”.

Through Patient Profile

Step 1: Access the Patient Tab

• From the main dashboard, click on “Patient Tab.”

Step 2: In the Patients Tab:

• Search and select the patient’s name.

Step 3: Select “Consults”. 

Step 4: Click on “View”.

Step 5: Select “Patient Info” and then click on “Insurance” to access the insurance information.

• Before proceeding, ensure that the billing provider is selected.

Step 6: Click the “Search Icon” next to the Insurance Name field.

Step 7: From the insurance list, search for and select the appropriate billing provider.

Step 8: Save the billing provider by clicking “Save”.

Step 9: Save the updated insurance details by clicking “Save” again.

Step 10: Select “Check Eligibility” to view the insurance eligibility information.

• The saved insurance details will automatically populate here for review.

Step 11: Click “Check Eligibility” to initiate the eligibility verification process.

Step 12: If required, you can print the eligibility results by clicking “Print Result”.

This process ensures that the patient's insurance coverage is verified accurately, streamlining administrative workflows and preventing delays in care or billing.