Patient Eligibility Enhancements

Overview of recent updates to the Patient Eligibility Response interface.

Overview

This document outlines recent updates to the Patient Eligibility Response interface. These changes are designed to streamline data presentation, improve navigation efficiency, and prioritize high-value information.

Insurance Overview
Summary Response

Summary

Summary Response

Field Updates

Following fields have been removed as they were identified as low-usage data points:

  • Date of Birth (DOB)
  • Address
  • City, State and Zip Code in patient section

We have introduced several new disabled fields in summary:

  • Coverage Service Types
  • Relationship to Subscriber
  • Group Name also introduced alongside with Group ID
New Fields

Note: When the user hovers over the coverage service field, a tooltip displays the description of that service type.

Hospice Status

If patient is hospice a red status will appear Infront of the name as "Patient in hospice".

Hospice Alert
Coverage

We have introduced 'All Network,' 'In Network,' and 'Out of Network' tabs. Selecting a tab filters the coverage grid to show only the relevant data.

In coverage grid we have renamed "amount" column to "Status", and previously we had active and in active as column fields which is now changed to covered and non-covered.

Coverage Grid
Non-Covered Items

Patient Eligibility Response - Noncovered:

Noncovered Items
Co Payment

Patient Eligibility Response - Co Payment:

Co Payment
Co Insurance

Patient Eligibility Response - Co Insurance:

Co Insurance
Primary Care Provider

Patient Eligibility Response - Primary Care Provider:

PCP Info
Plan Maximums and Deductibles

The separate tabs for Deductible, Limitations, and Out of Pocket have been removed. These fields are now grouped together within the new Plan Maximums and Deductibles window.

Plan Maximums
Benefit Information

We have introduced a new Benefit Information tab. This section displays a list of all covered patient benefits as expandable cards. Opening a card reveals detailed information such as Insurance Type, Co-Pay, and Co-Insurance.

Benefit Information
Other Information

Patient Eligibility Response - Others:

Others