Perform Patient Eligibility Check from the Workflow Module

NextGen® Enterprise EHR Help

Perform Eligibility Check for a Batch from the Workflow Module

You can check the eligibility for all patients scheduled to have an appointment for current day. To perform the eligibility check for patients in a batch, you must have either SureScripts services enabled. In NextGen® Enterprise EHR, select File > Work Flow. Select the Appointment icon. Select Batch 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

Types of Patient Eligibility Check

NextGen® Enterprise EHR supports the following types of patient eligibility check: Automatic check upon creation of a new encounter if the Perform Eligibility Check on New Encounter universal preference is enabled Manual check using the appointment list of the Workflow module Automatic check upon opening the Medications module Manual check using the Medications module Parent topic: Eligibility Check

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

NextGen® Enterprise EHR Help

Rx Change Requests in the Workflow Module Inbox

The Clinical Tasking tab on the Workflow window displays your outstanding tasks. For an Rx Change request, you can approve, approve with changes, or deny it on the Clinical Tasking list. For more information about the Clinical Tasking tab, go to NextGen Healthcare Success Community and download the Workflow Module Guide for NextGen® Enterprise EHR. A patient Inclusion or Exclusion List may restrict your access to Rx Change requests. If you are a workflow delegate for another user or provider, you may not be able to access the same refill requests as that person. If you do not have access to a patient, the Restricted message appears under the Patient Name, Subject, and Description columns. For more information about Inclusion and Exclusion List viewing restrictions, go to NextGen Healthcare Success Community and download the latest versions of the following documents: System Administrator Guide for NextGen Enterprise Patient Demographics Guide for NextGen Enterprise Orders Module Guide

Perform Patient Eligibility Check from the Workflow Module

Before you begin

Recommendations

Perform Eligibility Check for a Batch from the Workflow Module

Perform a Manual Eligibility Check

Types of Patient Eligibility Check

Eligibility Check

Check Batch Rx Eligibility

Rx Change Requests in the Workflow Module Inbox

Perform Eligibility Check for a Batch from the Workflow Module

Perform a Manual Eligibility Check

Types of Patient Eligibility Check

Eligibility Check

Check Batch Rx Eligibility

Rx Change Requests in the Workflow Module Inbox