Configure 270/271 Batch Eligibility Verification - PM

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In order for providers to ensure their clients are eligible for the services they plan to provide, we have enhanced the batch 270 eligibility request and 271 response processes. These enhancements streamline the process for ensuring clients are eligible for service at the time of their appointments and prior to billing.

Capabilities

Set up the Payer ID on the 270 section in the Guarantors/Payors form to reduce the number of templates required
Submit eligibility with a Medicaid ID as the Subscriber Policy Number for clients who are covered under an MCO
Submit eligibility requests to Medicaid for clients who have services distributed to self-pay
Set up minimum search options per guarantor based on the companion guide and validate that the client has values saved in order for a 270 request to be submitted
Define dates that will be accepted by the payer (past, future, current, ranges, single date)
Exclude clients with expired coverage from a batch 270 request
Submit a batch eligibility request with clients and service date ranges that meet specified criteria
Run eligibility requests in the System Task Scheduler
Export 271 response data into .csv files so staff can easily review the eligibility information received:
- Clients with Active Eligibility
- Inactive Clients + Clients Needing Review
- Benefit Information
- Validation Errors
- Updated Information

myAvatar Pre-Installation Process

Prior to installing the necessary updates for the 270/271 Batch Eligibility Verification enhancements in a LIVE environment, Netsmart strongly recommends installing the updates and performing thorough testing in a test region.
The most recent updates can be downloaded from the Product Update Portal: https://portal.ntst.com
In order to utilize the full capabilities of this feature, the agency must have enabled and configured applicable payers for the 270/271 transaction set.
The following registry setting must be set to ‘Yes’: Enable 270/271 Transaction Sets
On the Guarantors/Payors form, the Support 270/271 Transaction Sets indicator must be set to ‘Yes’.
Guarantors must be configured in Guarantors/Payors and a template created in Guarantor/Program Billing Defaults
If your organization wants to receive notifications by email when the eligibility request process has been run through the System Task Scheduler, then they will need to ensure sure that email settings are properly configured on the form System Generated Email Settings.