Skip to main content

How Financial Eligibility Works - PM

  1. Last updated
  2. Save as PDF
  • Once a guarantor is assigned, a Benefit Plan can be linked to that guarantor. While the guarantor provides billing and demographic data, the Benefit Plan identifies which services will be covered by the guarantor. This results in the service's liability distributing to that guarantor.
  • Avatar PM confirms that client records exist in the Financial Eligibility or Fast Financial Eligibility forms.
  • Liability is processed if a record is found. This process is repeated until total liability is distributed, or no client guarantors remain.
  • If no guarantors are available and there is remaining liability, liability is distributed to the Netsmart Default Payor (99999).
  • This process is repeated for the Cross Episode Financial Eligibility and Family Financial Eligibility forms.