Insurance Verification: Manual Verification & Statuses

  • Manual Insurance Verification

    In our ongoing effort to phase out legacy systems, we are migrating vital elements from the legacy appointments tab to the "Appointments List" within Scheduler. 🎉 

    When looking at the new appointment feature, users will now be able to see their patients for a given day with their insurance status at a glance. 

    To initiate insurance verification manually, mark as self pay or manually verified:

    1. Access the Scheduler app within RevenueWell.
    2. Open the Appointments List.
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    3. Patients who have not yet been automatically verified will show the "Unknown" status. Click on the hyperlinked verification status to the far right.
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    4. Within the verification dialogue box, you have the options to:
      1. Mark as "Manually Verified"
      2. Mark as "Self Pay" 
      3. "Run Verification" 
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    5. Once you have selected your option, the status will change accordingly.

    A patient's status will show as "Unknown" until the automatic process runs (three business days prior to patient appointment) or the patient is manually marked as "Self Pay" or "Manually Verified."

  • Download & Print Verifications

    To manually download insurance reports for patients with verified insurance:

    1. Access the Scheduler app within RevenueWell.
    2. Open the Appointments List.
    3. Click on the hyperlinked verification status to the far right.
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    4. Click "Download Verification PDF."
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    5. Navigate to your computer's "Downloads" folder.
    6. Select the newly downloaded Insurance Verification Report or Eligibility Report.
    7. Upload the chosen report to your PMS document center

    To print your appointment list and patient verification statuses for the day: 

    1. Access the Scheduler app within RevenueWell.
    2. Open the Appointments List.
    3. Select "Print" at the top of the list to print your appointment list and verification statuses for the day. 
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  • MFA Alerts [Pro]

    Certain payers will require multi-factor authentication (MFA) when accessing their portal. Should any MFA issues arise, customers will be notified with an alert located within the payer setup tab in the Insurance Verification settings. 

    Alerts can include:

    Credentials Invalid
    Authentication Timed Out
    Code Required

    If a patient's carrier displays an MFA error, we'll proceed with verification. However, the patient verification status will include a warning that due to the MFA error, we were only able to access EDI data.

    Keep reading for further details on verification statuses! ➡️

  • Verification Statuses

    Learn more about each verification status below. ⬇️

    Insurance Verified

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    In addition to this "Insurance Verified" status, there are a variety of warnings that might populate with a verification.

     

    Warning #1: Missing Portal Credentials [Pro]

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    Warning #2: Invalid Portal Credentials [Pro]

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    Warning #3: MFA Error [Pro]

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    Warning #4: Patient Data Error [Pro]

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    Warning #5: General Portal Error [Pro]

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    Unknown

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    Verification in Process

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    Self Pay

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    Manually Verified

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    Retry in Progress

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    Insurance Inactive

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    Insurance Termed

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    Data Missing

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    Payer Not Setup or Supported

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    If you are seeing the "Needs Attention" icon, there are a variety of status descriptions you might see explaining what action is required. Click through the carousel below to see each possible "Needs Attention" status. ⬇️

    Needs Attention #1: Inaccurate Data

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    Needs Attention #2: Provider NPI Missing

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    Needs Attention #3: Invalid Provider NPI

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    Needs Attention #4: Provider Relationship Error

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    Needs Attention #5: Provider Not Registered

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    Needs Attention #6: Unknown Error

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  • Frequently Asked Questions

    Question Answer
    What happens to appointments that are on the first days of the month? RevenueWell will automatically re-run verifications on the morning of the 1st of the month for any appointments that straddled the end of the month.
    What clearinghouse does RevenueWell use? RevenueWell aggregates data from the four main clearinghouses.
    Does the Carrier ID or Primary member ID get pulled in from the PMS? The Primary Member ID is pulled from the PMS.

    We are working to be able to pull in the Carrier ID as well in the future.
    When patient data is missing or inaccurate, what are the most common things to review? Although clearinghouses and payer portals don't specify what is missing, we recommend checking the member ID, birthday, etc.

    We are working to provide more detailed information as we can.

    Feel free to review Patient Data Management resource for tips on maintaining clean patient data.
    When reporting an issue, what information should we provide to the support team? Please provide the patient name, appointment date and time, and the error message you are seeing.
    Why do some of my verifications run automatically but others don't? All verifications run three business days prior to the appointment. To run a verification on the same day or further in advance, open the verification status and manually run or re-run it.
    How long does it take to sync when you put in a new patient's insurance information? It takes 15 minutes to sync, after which verifications will run according to our standard of three business days before the appointment, with the option to manually verify or re-run the verification as needed.
    If we have two doctors in the office and they have a different relationship with an insurance carrier, how does that work? When defining the relationship with the payer in Payer Setup, you can set the default relationship and specify provider-specific exceptions.
    [Pro] If carrier portal credentials are invalid, will we still see an insurance verification status?

    [Pro] Yes, you will see a relevant warning within the verification status description indicating that we can only pull EDI data until the payer portal is connected.

    See our verification statuses for more information on what these warnings might include.