Our your EC-Claims Portal you will be given 30 benefit/eligibility checks (EC) and prior authorizations per month at no additional charge. If you were to go above that it would be $3.00 each time. The 30 benefit checks will reset on the first of each month and there is a ticker to keep track for you every month from your end.
1. If you ever receive an EC back from CODE and the individual deductible and out of pocket maximum shows $0 for both deductible amount and accumulation is also $0, then look slightly more your right and see if there are any number in the family deductible section. These types of EC responses usually mean there is actually a family deductible in play for all individuals on the policy rather than one person. Therefore, for the plan to pay the family deductible would have to be met first.
2. If you are requesting an EC on an EPO plan, HMO plan, or high deductible plan and want CODE to explore a GAP waiver option please let us know by typing into the additional comments just to the right of the chosen code on your portal “Please check for GAP waiver”.
3. If you ever need an educated guess on the allowed amount based on historical averages from our numerous EOB’s please post that request in document management. Remember to make the topic post your patient’s name.