Verifying Aetna + Humana

purpose to verify a patient’s eligibility and chiropractic benefits for aetna or humana insurance, including deductible, out of pocket, coinsurance, and copayment details, and to save a pdf copy for the patient record when use this process when a patient has aetna or humana insurance and the office needs to confirm active coverage and chiropractic benefit details before the visit or before discussing financial responsibility who this process should be completed by the front desk, insurance verification coordinator, or other designated team member responsible for benefit verification https //apps availity com/availity/web/public elegant login https //apps availity com/availity/web/public elegant login user id hstriad password changes every 3 months, check password book located at reception desk procedure 1\ log in log into the insurance verification portal purpose to access the patient’s eligibility and benefits information 2\ open eligibility + benefits inquiry go to eligibility + benefits inquiry purpose this section is used to check the patient’s active coverage and plan benefits 3\ select the payer in the payer field, select the patient’s insurance aetna , or humana purpose ensures the inquiry is sent to the correct insurance carrier 4\ select a provider choose select a provider and pick the appropriate provider option purpose connects the eligibility request to the correct treating provider or office 5\ enter patient information scroll down to patient information and enter all required patient details purpose identifies the correct member record for the benefit check 6\ submit the inquiry click submit purpose sends the request and loads the patient’s eligibility and benefit details coverage review 7\ open coverage and benefits after the inquiry loads, go to coverage and benefits purpose this section shows the patient’s financial responsibility and benefit structure 8\ review deductible, out of pocket, and coinsurance acknowledge and review the following deductible amount out of pocket amount co insurance important note once the out of pocket maximum is met, the patient is covered at 100% purpose helps determine what the patient may owe and when insurance begins paying in full 9\ check chiropractic copayment on the left hand side , go to chiropractic > co payment review whether a chiropractic copay is listed purpose confirms whether the patient has a fixed copay for chiropractic services 10\ if no copayment is listed if there is not an option for co payment , then select co insurance interpretation if only co insurance appears, this usually means the deductible applies to chiropractic services purpose identifies when the patient’s chiropractic visits are subject to deductible and coinsurance instead of a copay printing and saving 11\ go to print select print purpose creates a record of the verified benefits 12\ select chiropractic choose chiropractic as the section to print purpose prints the benefit details specific to chiropractic coverage 13\ print and save as pdf click print the document will generate as a pdf save the pdf to desktop , or designated patient benefits/verification folder purpose keeps a copy of the insurance verification for documentation and future reference documentation notes be sure the saved pdf clearly shows insurance payer deductible out of pocket amount coinsurance chiropractic copay, if applicable whether deductible applies to chiropractic purpose provides proof of benefits reviewed and supports patient financial discussions