- Editing/Viewing a patient’s Insurance information can be done by clicking the white paper/blue pencil logo on the far-right of the patient’s name. The grey paper/pencil logo is to put you in Edit mode.
- Adding a Secondary medical insurance plan can be done by clicking the “Add New Record” button on the far-right side.
- The “Expected Date of Service” calendar is where you choose a “Target Date” for the service/procedure you want to perform. If you do Not have a target date, you can just choose tomorrow’s date as a placeholder, it will Not affect your Benefit Check, Pre Authorization or Claim.
- The “Additional Comments” box will only be seen by the CODE team for Special Requests about Benefit Checks. Do Not put SOAP notes in the Additional Comments box and you are not able to include attachments for Benefit Checks. Examples of Additional Comments that you may want to tell the CODE team is that you want to know the frequency limitations for an Oral Appliance or want to ask about multiple ADA codes in one Benefit Check (i.e. you chose D7210 from the drop-down menu, but also typed in the Additional Comments box that you want to know about D7953 (Bonegraft) and D6010 (Implant).
- A common note in the Additional Comments box of Benefit Check is to Request a “GAP Waiver” or an “In-Network Exception” when your patient has an “In-Network Only” plan like an HMO or EPO that your office has a Non-Participating status with. If a GAP Waiver is Approved, you will be granted the option to file a one-time Claim with In-Network benefits.
- All your Benefit Check requests are saved on the grey menu/tab “Requested Eligibility Check”. When you click that menu/tab, New requests will be noted as “Waiting for CODE action” and is on the CODE team’s call list. We ask for 24-48 hours to complete the Benefit Check call for you and then the Status will be updated to one of three statuses: Rejected, Continue with Pre Authorization or Continue to submit Claim. You will always get an email notification, you do not have to check the Requested Eligibility Check tab/menu every hour/day.
- Also when a Benefit Check request is completed and the Status has been updated, you will be able to click on the “View EC Response” link on the far-right to view the letter about the CODE team’s findings on the Benefit Check call.
Benefits & Eligibility Request
