Eligibility Patient Demographic Query & Update

In Medisoft Version 25 you can now complete a new or existing patient’s demographic and case information as part of an eligibility check in Medisoft or Office Hours. Once basic information for the patient has been entered into Medisoft or Office Hours, performing an eligibility check will populate patient data into the existing Pending Patients feature. Then, you can update and import that information into the patient’s record.

Eligibility information

• When an eligibility request is sent, it will use the current system date, just as it does for the existing eligibility feature (F10).
• The patient’s insurance carrier may or may not send complete demographic information back with the Eligibility Request. Each payer is different.

As part of this feature, several updates have been made in Medisoft.

Updated Patient List screen
There is a new button on the Patient List screen: New Patient Quick Add/Query.

In addition, there is a new right-click option on a selected case: Patient Demographic Query. Selecting this option will initiate an eligibility request and then Pending Patient. You can also initiate the eligibility request by selecting the case and pressing Ctrl + F12 on your keyboard.

Updated New Appointment Entry screen
There is a new right-click option on the Chart field of the New Appointment Entry screen in Office Hours.

Updated Appointment screen
There is a new option on the right-click menu for the Appointment screen: Patient Demo Quick Query. Select this option to conduct an eligibility request that will return patient data that you can use to update an existing patient’s record using Pending Patients.

New Save & Query button
There is a new Save & Query button. Use this button to save an appointment and initiate an eligibility request and then launch Pending Patients to update demographics.

New Patient/Quick Add Screen
This screen is opened when you click the New Patient/Quick Add/Query on the Patient List screen in Medisoft or the New Patient Quick Add/Query right-click link on the Chart field of New Appointment Entry in Office hours.

Pending Patients in Office Hours
Pending Patients will now launch in Office Hours after performing a Save and Query or a Patient Demo Quick Query. This screen will open when an eligibility request is complete and patient data has been returned from the eligibility check.

Existing patient information appears in the left-hand column and information from the eligibility check appears in the right-hand column. Select the fields in the right-hand column that need to update the patient’s record. You can use the Check All check box at the bottom to select all of the fields. Then, click Save to make the changes to the patient’s record.

Note: The Case Default field on the Data Entry tab in Program Options determines which Case is defaulted (lower right). You can select a different case or create a new case as needed. If your Program Option is set to Last Used, there will be no default for a patient/case created using the New Patient Quick Add.

Eligibility check for new patient

1. Select Lists > Patients/Guarantors and Cases. The Patient List screen opens.
2. Perform a search to verify that the individual is not listed as a patient.
3. Click the New Patient/Quick Add/Query button. The New Patient/Quick Add screen opens.
4. Complete the fields on this screen for the patient.
5. Click the Save button.
6. The system performs an eligibility check and the Eligibility Verification Results screen opens.
7. When you close the screen, the Pending Patient screen opens.
8. Verify the updated data and select the check boxes for the fields that will update the patient’s
   record.
9. Click

Eligibility check for existing patient

1. Select Lists > Patients/Guarantors and Cases. The Patient List screen opens.
2. Select the patient and then the associated case.
3. Right-click the case and select Patient Demographic Query from the menu.
4. The eligibility check is performed and the Eligibility Verification Results screen opens.
5. When you close the screen, the Pending Patient screen opens.
6. Verify the updated data and select the check boxes for the fields that will update the patient’s
   record.
7. Click the Save button.

Eligibility check for new patient in Office Hours

1. On the Activities menu, select Appointment Book. Office Hours opens.
2. On an empty appointment slot, right-click and select New Appointment. The New Appointment screen opens.
3. In the Chart field, right-click and select New Patient Quick Add/Query. The New Patient Quick Add screen opens.
4. Complete the fields on the screen for the patient.
5. Click the Save button. You are returned to the New Appointment screen with the new patient chart populated and some of the fields are completed.
6. Complete the appointment details.
7. Click the Save & Query button. The eligibility check is completed and displays the results.
8. Close the Eligibility Verification Results screen. The Pending Patients screen opens.
9. Select the information in this screen that you want to transfer to the patient’s record.
10. Click the Save button.

Eligibility check for existing patient in Office Hours

1. In Medisoft, select Activities > Appointment Book. Office Hours opens.
2. Right-click on an appointment slot and select Patient Demo/Quick Query.
3. The eligibility check runs.
4. Close the Eligibility Verification Results screen. The Pending Patients screen opens.
5. Select the data that you want to update the patient’s record.
6. Click the Save button.