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The application retrieves the benefits eligibility information for the patient from the DrCloudEHR database. If the patient's insurance coverage has changed, you can send a benefits eligibility inquiry electronically to the clearinghouse used by the patient's insurance company. 

  1. Search for the patient.
  2. Click the Benefits button on the patient page. 
    The application displays the results of the request to retrieve data from the database in the table below. Click the icon in the Action column to view the information retrieved.
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    Enter the following information:
    • Select the service category as defined by the insurance company from the Service Code menu.
    • Select the name of the provider/clinician providing treatment.
    • If you want to submit a benefits inquiry through the clearinghouse used by the insurance payer, select the name of the EDI connection to use from the X12 Partners menu.
    • Select the patient's insurance company and the provider providing treatment.
  4. The application displays the results of the request to retrieve data from the database in the table below. Click the icon in the Action column to view the information retrieved.
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  5. If the patient's insurance coverage has changed, click Get Latest Benefits Benefits benefits to submit an eligibility inquiry electronically to the clearinghouse. The 
    The application displays the results of the inquiry in the table below. Click the icon in the Action column to view the inquiry response from the database.
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Verify Benefits and Eligibility for One or More Patients 

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  1. Click the Billing tab.
  2. Click Eligibility & Benefits in the left hand navigation bar.
  3. Enter the following information:
    • Select the dates the inquiry requests were submitted. This information might be helpful if you want to view the status of requests made over multiple days.
    • Select the patient's insurance company and the provider providing treatment.
    • Select the service category as defined by the insurance company from the Service Code menu.
    • Select the patients you want to retrieve data for.
    • If you want to submit a benefits inquiry through the clearinghouse used by the insurance payer, select the name of the EDI connection to use from the X12 Partners menu.
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  4. Select one of the following options to retrieve benefits data:  
    • Click Search from DB to retrieve the information directly from the DrCloudEHR database
      Click the icon in the Action column to view the information retrieved.
    • If Click Generate Eligibility Benefit if you you need to update retrieve the benefits eligibility data for a patient, click Generate Eligibility Benefits
      The application sends a displays a list of selected patients with the status of the request to retrieve the data.
      • Click the icon in the Action column for a patient.
      • Enter the details described in Verify Benefits Eligibility for a Single Patient
      • Click Get Latest Benefits to submit an eligibility inquiry electronically to the clearinghouse. The application displays the results of the inquiry in the table below. Click Click the icon in the Action column to view the inquiry response from the database.
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