Ability Insurance Verification Integration

Enquire's integration with Ability allows you to verify an individual's insurance coverage using their primary and secondary insurance providers and Medicare.

Insurance and Medicare fields

Insurance eligibility checks use the individual's insurance information that must be populated to specific fields. An admin will need to add the following Field Library fields to a form:

  Primary Insurance Policy Number   Primary Insurance Provider
  Secondary Insurance Policy Number   Secondary Insurance Provider
  Medicare Number

These fields can be added to an existing form or a new form can be created for them.

insurance_form.png

Note: Read our Customizing the From Builder article if you need help adding these fields to an existing or new form.

Check eligibility

  1. Navigate to the profile where you'd like to check insurance eligibility.
  2. Ensure the individual has a valid birthdate and private insurance information or Medicare number populated to the necessary fields.
  3. In the upper right of the profile, click the blue Check Eligibility button.
    check_eligibility_button.png
  4. You will be presented with the insurance eligibility modal displaying the individual's insurance information and a Service Type Code field (insurance and Medicare fields will be displayed depending on whether or not a value was provided when the button was clicked). If needed, you may make changes to the primary and secondary policy numbers and Medicare number on this modal before checking eligibility, but note that your changes will persist to the respective field after the eligibility check has been completed.
    insurance_eligibility_modal.png
  5. Select one or more Service Type Codes to check. Hold the control key on your keyboard and click to select multiple values.
  6. Click Verify.
  7. Once insurance verification has been completed, the modal will update to display coverage.
    insurance_check_confirmation.png

    The verification symbols indicate the following:

      The service type code is covered by one or more insurance providers or Medicare.
      The service type code isn't covered by the specified insurance provider or Medicare.
      The service type code isn't covered by any insurance provider or Medicare.

Insurance verification notes

Once an insurance check has been completed, refresh the page and click the individual's Notes tab to view detailed information regarding the insurance eligibility check.

ability_notes.png

Medicare

Medicare eligibility may require an additional step in order to complete eligibility checks. If you receive an error with the code of 41 or 42, please reach out to your account manager.

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