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Enable Eligibility Check - Registry Setting

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'Y' enables the following logic:

  • The Eligibility Check section is enabled in the Funding Source/Guarantor Mapping form.
    This section allows the eligibility validation method to be defined, as well as status and status reasons per funding source.
  • Confirm if eligibility has been verified for the authorized CPT code, for the following forms:
    Service Authorization, Service Authorization Request, Service Authorization (Unlimited Codes), Claim Processing (HCFA 1500), Claim Processing with Override (HCFA 1500), Claim Processing (UB92), Claim Processing with Override (UB92)Fast Service Entry.
    If eligibility has not been verified, the authorization status and authorization reason populate values entered in the Funding Source/Guarantor Mapping form (Eligibility Check section).

'N' disables this logic.


 

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