With batch eligibility, users can click a button to run eligibility checks for all active patients in real-time and create schedules to automatically run eligibility checks on existing clients at the desired intervals.
Enabling this functionality can help reduce claim denials due to inactive or ineligible coverage. Additionally, users will no longer need to verify patient eligibility chart by chart after admission, allowing users to spend more time focused on revenue-generating activities.
Enable Batch Eligibility: Batch Eligibility is enabled by default. To use, simply follow the instructions below to set up your Eligibility Check Schedule. The per-patient electronic eligibility rate still applies.
Run Batch Eligibility
Once you've configured the Eligibility Check Schedule, the system will automatically run eligibility on all active patients starting at midnight in the practice's timezone on the selected day. Schedules can be set to daily, weekly, or monthly.
Each time the Eligibility check is run:
- It will only check active patients
- When complete, the patient's eligibility result will be updated in the insurance set within the treatment episode.
- The Eligibility icon on the Patients page will be updated. You can hover over this icon to display the status sent from Waystar and the date the most recent eligibility check was completed.
Active Inactive Needs Review
- The Eligibility Status tab in the Work Center will be updated.
- The Eligibility History and Eligibility Batches tab in the Records Center will be updated.
Eligibility Batches (Records Center)
You can view all past run eligibility batches on the Records Center under VOB > Eligibility Batches.
On this page, you can filter by Organization, Practice, and Start/End Dates. The system defaults to showing batches for the last three months.
Batches are displayed in a table with:
- Control Number: This is the unique number assigned to the batch/
- Date: The date the batch was submitted.
- Patients: The number of patients in the batch.
Coverage Tiles (Management Center)
Two tiles are available to help manage Batch Eligibility. Navigate to Management Center > Dashboard > Organization Dashboard: Inactive Coverage and Coverage Needs Review.
Clicking on one of these tiles will direct the user to the Eligibility Status tab on the Work Center.
Eligibility Status (Work Center)
The Eligibility Status tab on the Work Center (under VOB and U/R) displays each patient with an active treatment episode and groups them into three segments: Inactive Coverage, Coverage Needs Review, and Active Coverage.
Click on the ⏵ icon to expand the eligibility status details.
Click on the Delete icon to remove a patient from this list. Please note that any time eligibility is rechecked for a patient that has been previously removed, they will be added back to this list.
Configure Batch Eligibility Schedule
Once enabled, you can configure an Eligibility Check Schedule to automatically run eligibility on all active patients.
- Click on Admin and choose Managing Org Admin.
- Click on Configuration and open the VOB tab.
- In the Eligibility Check Schedule, click Add Schedule.
- From the Create Eligibility Check Schedule window:
- Select the desired Organization.
- Choose a Practice from the drop-down.
- Select a Frequency: Daily, Weekly, or Monthly.
- Set the Schedule:
- Daily: Select the number of days between each eligibility check (e.g., every 5 days).
- Weekly: Select the number of weeks between each eligibility check (e.g., every 2 weeks). Then, select which day of the week to run the check.
- Monthly: Select the number of months between each eligibility check (e.g., every month). Then, choose which day to run the check (First, Last, or a specific day).
- Click Save.
- The schedule will display the Practice, Organization, Frequency, and Next Scheduled date.
Scheduled checks will batch overnight starting at midnight in the practice's timezone on the selected day.
Batch Eligibility User Permission
By default, Managing Org and Organization users will not have access to Batch Eligibility. Managing Org and Organization Admins automatically have access to configure eligibility check schedules and run manual batch eligibility checks.
To provision user access:
- Navigate to the Users tab of the Managing Organization Admin or Organization Admin.
- Click on the name of the user.
- Open the Permissions tab and click Edit.
- Under Patient Access, toggle on Bulk Eligibility.
- Click Save.