Insurance Verification List

This is useful for offices that verify Insurance Benefits and patient eligibility prior to appointments.

In the Appointment Lists, click Ins Verify.

See our video: Managing the Insurance Verification List Webinar.

The Insurance Verification list is managed manually. Use this list to quickly identify when insurance benefits and patient eligibility needs verification. Offices can also assign ownership of verifications, then track, change, and manage verification status. Set defaults for the list in Insurance Verification Setup. The Insurance Verification Security Permission is required for users to access this list.

Verification Filters

Change the criteria to change the results listed. These filters will affect all tabs. Set defaults in Insurance Verification Setup.

Insurance Verify List

The Verification List tab will be highlighted by default upon opening the Insurance Verification List. To preview insurance plan information, subscriber information, and verification status, highlight a patient or plan. The information will appear at the bottom. To open the Insurance Plan, double-click a row, or right-click and click Go to Patient Plan.

Verifications are grouped by those that are current and those that are past due. Click a tab to view verifications that meet the criteria.

Insurance Verify List: Click on a column header to sort the list in ascending or descending order.

  • To change information, the Insurance Plan Edit security permission is required.
  • To exclude a plan from the list, check Don't Verify on the Edit Insurance Plan window.

Right-click Options: From the Verification List tab, right-click on a row to get the following options.

Insurance Plan and Subscriber Information

At the bottom of the Verification List tab, users will see insurance plan and subscriber information once a plan is selected.

Insurance Plan: Information for the selected insurance plan. Information is not unique to the selected patient. Includes information that may be necessary for office staff to contact a carrier and verify insurance benefits. Click Mark Ins Benefits Verified after verifying benefits to update last verified date.

Subscriber: Information for the subscriber of the selected insurance plan. Also includes birthdate for the selected patient, which may differ from the subscriber. This is information that may be necessary to verify patient eligibility when office staff contacts a carrier. Click Mark Patient Eligibility Verified after verifying patient eligibility to update the last verified date.

Verify Status: Click an Insurance Verification Status from the dropdown to set or update the Status and Status Date. The user will be prompted to enter a Status Note upon selecting a status.

Status Note: Insurance verification status note of the selected verification.

Assign Standard Verification/Assign Medicaid Verification

Users can be assigned to insurance verifcation from the two Assign Verification tabs. Column descriptions and filters are the same as the Verification List. Users must have the Insurance Plan Verification List Security Permission to be assigned insurance verification.

Plans will appear in the Assign Medicaid Verification tab when the Insurance filing code for the plan (set in Edit Insurance Plan, Other Ins Info Tab) is selected in Insurance Verification Setup, Show In Medicaid List When.

Plans with all other insurance filing codes or no selected insurance filing code, will list in the Assign Standard Verification tab.

For User filter will default to Unassigned to show verifications that have not yet been assigned to any user.

Right-click options:

Assign Standard Verification / Assign Medicaid Verification: Assign verification to specific users or set a status note from this area.

To User: Assign insurance verifcation to specific users.

  1. Select verifications to assign. Click and drag, Ctrl + click, or Shift + click to select multiple.
  2. Click [...].
  3. Select a user from the list. Click Select None to unassign verifications instead.
  4. Click OK.
  5. Click Assign at the bottom of the Insurance Verification List window.

The selected verifications are now assigned to the selected user (or unassigned if Select None was clicked). If the verification was previously assigned to another user, the verification is now only assigned to the new user.

Note: Enter a status note. When right-clicking and selecting Set Verify Status, any note typed into this box will automatically be added into the Add Status Note window.

Mark a Patient Eligibility (Pat) / Insurance Benefits (Ins) as Verified

There are several ways to mark patient eligibility and/or insurance benefits as verified. Marking a verification as verified will change last verified dates on the Edit Insurance Plan window.

Dates will update according to Insurance Verification Setup preferences:

Option 1:

  1. On the Verification List tab, right-click on a verification then select an option. Options will vary depending on the type of verification selected.
    • Verify Patient Eligibility: Mark patient eligibility as verified (Eligibility Last Verified date automatically updates).
    • Verify Insurance Plan: Mark insurance benefits as verified (Benefits Last Verified automatically updates).
    • Verify Both: Mark both patient eligibility and insurance benefits as verified (automatically updates both dates).
    A confirmation message will show.
  2. Click OK.

Option 2:

  1. On the Verification List tab, highlight the verification row. General insurance plan and subscriber information will show in the bottom of the window.
  2. Click one of the verified buttons:
    • Mark Patient Eligibility Verified: Mark patient eligibility as verified (Eligibility Last Verified date automatically updates).
    • Mark Ins Benefits Verified: Mark insurance benefits as verified (Benefits Last Verified automatically updates).
  3. A confirmation message will show. Click OK to confirm.

Option 3:

  1. On the Verification List tab, double-click a verification row, or right-click and select Go To Plan to open the Edit Insurance Plan window.
  2. To verify patient eligibility, manually enter a date for Eligibility Last Verified.
  3. To verify insurance plan benefits, manually enter a date for Benefits Last Verified.
  4. Click OK to save.