Real-Time Eligibility Verification from a Patient's Chart

DrChrono allows you to verify eligibility and see what type of benefits your patient has under their insurance plan before you provide services.

To access the Real-Time Eligibility tool, you first need to open a patient's chart (Patients > Patient List > Chart ID or search directly for your patient's name).
Select the Eligibility tab in the left-hand navigation pane.

Verifying Eligibility or Active Coverage

Ensure the patient's insurance information is loaded into their account; including the Payer ID for their insurance and their complete membership number.
Select Run Primary Insurance or Run Secondary Insurance, depending on which insurance you are verifying.

The system will ping the eligibility file provided by the payer and display the eligibility and benefit information obtained.

If the response is Cannot Process, it could be that the payer does not offer Real-Time Eligibility Checks, the payer ID is incorrect or missing or the patient ID number is wrong or missing.

Checking Benefit Level/Services Covered

You are also able to check benefits/services covered for a particular specialty

Search for one or multiple from the specialty drop-down.
Select Run Primary Insurance or Run Secondary Insurance.

If you don't select a specialty, the function will return benefits for any/all specialties listed on the eligibility and benefit file provided by the payer.

Here you can view all the plan's coverage details about the specialty you have selected.

Past Eligibility Checks

By selecting the Past Eligibility Checks tab, you can view eligibility checks previously run for the patient. You can filter by date of appointment, the date eligibility was checked, and sort by heading type. Failed eligibility checks are also recorded here.