Notes and Benefit Customization

James McKinley de Vance Updated by James McKinley de Vance

You may sometimes find it necessary to add additional information to the benefits pulled with Eligibility AI, add notes for a particular patient/appointment, or override a benefit entirely. This article will cover how to do so.

Adding additional information

If you need to add additional information, simply navigate to the appointment date for the patient in question and click on their name from the list.

Once you are on the patient's appointment, navigate to the "Coverages" tab towards the top, and click the 'circle plus' icon to expand whichever coverage category you want to add information to. (Alternately, you can manually add a code's benefits by clicking the "new benefit" button in the top right corner of the coverages screen.)

In our example we will be adding co-pay and frequency information for code D9230

Once you have the benefit class expanded, and have located the code, simply click anywhere in the procedure code's box, and the coverage details window will pop up. As you can see below, we have added the co-pay and frequency. You can also use the note section here to mention where the manual information entered came from.

You will be able to adjust certain pieces of information on a benefit depending on how it was pulled. Because this benefit was pulled from the payer's portal, you cannot change the code, the Network Type or the Network Name. Once you have added all of your additional information, click "save" to have your manual entries added to the patient's benefit information.

You'll notice that the co-pay and frequency information has a pencil icon next to them to denote they were entered manually. There will also be a speech bubble that you can hover your mouse over to read any note that was added.

You would follow the same process for adding an additional procedure code benefit, also selecting the code itself, Network type, and Network name. Here we have added another benefit for code D9230 under a different network name.

Once you click save, the procedure code will show up under the patient's coverages tab along with any other codes pulled from the portal. Much like manually added benefit information, manual codes will show a pencil icon to denote they were entered manually. You can click on the manually entered code to view any notes added to it as well.

How did we do?

Manually Running an Eligibility Check

Reviewing Eligibility & Benefit Details

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