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Eligibility History window

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Path: Patient > General > Payers > Eligibility > Show History

You can use the Eligibility History window (available only in Host Mode) to do the following:

  • View the eligibility history for the number of months set up in the Netsmart Homecare Service Manager (default is 18 months).
  • Manually enter eligibility information for the patient if the insurance code and company in the Pay Source section are also defined in the Online Eligibility window (Administration > Configuration > Organizations > Online Eligibility).

Tabs at the top of the window correspond to the ageing of the eligibility responses. Each tab represents three months of eligibility. The application calculates the dates based on the current date:

  • Current date minus 90 days (90 days back).
  • Current date minus 91 days to 180 days back (91 to 180 days from current date).
  • Continue at three-month intervals up to 18 months (540 days).

Click the corresponding tab to view the eligibility information for the date range needed.

  • Each tab holds 90 days of verification data in reverse chronological order, for example 10.23.08 – 07.24.2008.
  • This date range is displayed as the name of the tab.
  • A new tab is added automatically as time passes.
  • To view specific verification data, click the tab with the date range that contains the verification date.

This window contains the same fields as the Eligibility tab in the Payers window. Refer to Pay Control – Eligibility tab for the detailed description of each field.

  • Eligibility information can be added manually to the patient's record by clicking the Insert Row button to the right of the grid.
  • When you select a row from the grid, the eligibility message that corresponds to that row is displayed in the text box in the bottom of the window.

When a new eligibility record is entered manually, the Reviewed check box is clear. When the check box is selected, the application completes the Date Reviewed and Reviewed by fields with the corresponding data.

You must have Full access to Patient > General > Payers and Patient Eligibility tab to manually add data to a patient's record.

You can also view the read only Message section that contains the text of the actual verification report received for the patient.