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How to Run an Eligibility Check

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This page is a placeholder. Steps and a walkthrough embed still need to be added — see the TODOs below.

Overview​

An eligibility check confirms a patient's medical coverage — plan status, deductible, and benefits — before you build a claim. Running one early helps you catch coverage problems before a visit instead of after a denial.

Before you begin​

Your practice must be enrolled for Eligibility transactions with the payer. See Enrollments if you haven't set that up yet.

Steps​

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Reading the benefit summary​

For background on what the fields in an eligibility response mean, see Reading Eligibility Checks in the Medical Billing Guide.

Next steps​