Perform Eligibility Check for a Batch from the Workflow Module

NextGen® Enterprise EHR Help

Perform Patient Eligibility Check from the Workflow Module

Before you begin To perform a patient eligibility check, you must have either SureScripts services enabled. You can check a patient's eligibility from the appointment list of the Workflow module. In NextGen® Enterprise EHR, select File > Work Flow. The Workflow module opens. Select a patient's appointment. Right-click and select Check Rx Eligibility. The application sends an eligibility request. A message indicating that the eligibility check was successfully sent appears. Select OK. Parent topic: Eligibility Check

NextGen® Enterprise EHR Help

Perform a Manual Eligibility Check

To perform a patient eligibility check, you must have Surescripts services enabled. Open NextGen® Enterprise EHR, and select a patient from Patient Lookup window. To view the Medications module for the patient, select Medications on the Quick Buttons panel. The Medications module opens. If the eligibility status displays No eligibility status, select Eligibility.The Checking Patient Eligibility window opens. While the NextGen® Enterprise EHR is acquiring information, the eligibility status is Pending. When the NextGen® Enterprise EHR acquires the available patient eligibility information, the status changes to Eligible. If the patient is not eligible, the status displays Not Eligible. Note: A patient can have multiple eligibilities. If you want to view the details of a patient's eligibility, select the eligibility status.The Patient Eligibility window opens. You can then select specific pharmacy benefit manager from the Benefit Source field. Patient Eligibility A patient eligibility ch

NextGen® Enterprise EHR Help

Eligibility Check

If you enable Surescripts® in File Maintenance, you can perform an eligibility check for a patient. The eligibility check for each patient can be performed once in 72 hours. If you run a batch eligibility check in the morning for all patients with appointments and then open the Medications module, NextGen® Enterprise EHR automatically verifies when the last eligibility check was performed. If it has been more than 72 hours since the last eligibility check, NextGen® Enterprise EHR automatically sends the following patient information to the Surescripts® network for eligibility check: First name Last name Date of birth Gender Zip code Types of Patient Eligibility Check Patient Eligibility Status Perform a Manual Eligibility Check Eligibility check enables you to perform a manual eligibility check. Perform Patient Eligibility Check from the Workflow Module Perform Eligibility Check for a Batch from the Workflow Module Parent topic: Supported ePrescribing Features Parent topic: Layout of M

NextGen® Enterprise EHR Help

Check Batch Rx Eligibility

You can check the prescription (Rx) eligibility for all patients scheduled to have an appointment for the same day. Note: To perform a batch Rx eligibility check, you must have either Surescripts or RxHub services enabled properly. From the Appointments menu, select Batch Rx Eligibility. NextGen® Enterprise EHR sends an eligibility request. Note: Depending on the number of appointments for the current date, this process may be time consuming. The confirmation message on Eligibility Check window opens to inform you that an eligibility check was successfully sent. Select OK. Parent topic: Appointments

Help Guide for NextGen® Enterprise PM 8

Submit Eligibility Requests

There are several ways to submit eligibility inquiries: NextGen® Eligibility Verification Submission NextGen® Eligibility Verification Batch Submission Scheduled Batch through NextGen® Background Business Processor NextGen® Eligibility Verification transactions are submitted from different NextGen® Enterprise PM access points. The access points are Patient Lookup Appointment Book Appointment List Encounter Lookup From any of these access points, a NextGen® Eligibility Verification request can be submitted for a single patient by right-clicking on the patient, appointment, or encounter, and then selecting Eligibility Verification. Regardless of the access point, the user interface is the same. Several inquiries can be submitted at one time using batch mode. Manually submitting a batch of eligibility inquiries can be done from the appointment lookup and encounter lookup. This manual batch was referred to as Real Time batch. (Long time RTS users also know this as pseudo-batch.) Finally, b

Help Guide for NextGen® Enterprise PM 8

Run an Eligibility Batch Manually

This type of select-and-submit batch submission is a NextGen® Eligibility Verification Batch. (Long-time RTS users may know this as a pseudo-batch.) In NextGen® Enterprise PM, select Tasks > Lookup, > Appointments. The Appointment Lookup window opens depending on whether you are submitting the inquiry from an appointment. Enter the search criteria and select Find. Select the appointments for the patients that you want to include in your batch submission. You must select more than one appointment from the list for batch processing. Right-click a patient and select Eligibility Verification and then select Submit. The Eligibility Verification Batch Request window opens. Uncheck the Submit in Batch Mode to queue and process one at a time. You get your result in real time. The amount of time it takes to complete is based on the number of appointments. Note: If you leave the Submit in batch mode box checked, the inquiries are queued and sent to NextGen® Background Business Processor. The res

Perform Eligibility Check for a Batch from the Workflow Module

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Perform Patient Eligibility Check from the Workflow Module

Perform a Manual Eligibility Check

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Submit Eligibility Requests

Run an Eligibility Batch Manually

Perform Patient Eligibility Check from the Workflow Module

Perform a Manual Eligibility Check

Eligibility Check

Check Batch Rx Eligibility

Submit Eligibility Requests

Run an Eligibility Batch Manually