MediClaim now has real-time on-line MSP eligibility checking.
You can quickly determine if your patient has coverage with MSP.
You can also check patient eligibility for supplemental benefits.
That's important for supplemental benefit providers :-
Acupuncturists
Chiropractors
Massage Therapist
Physiotherapists.
Optometrists may also use this feature to confirm the date of a patient's most recent eye exam.
Supplementary Practitioners can determine if the available benefits have been exceeded. Other patient insurance restrictions are also presented on-line.
USING THE `CHECK ELIGIBILITY`FEATURE
To use the eligibility checking feature, go to Edit Patient/New Patient on the patient profile TAB, find the patient or enter the new patient data and then click on the Check Eligibility button. A text message will appear with details of the patient's status with MSP. After eligibility has been verified, you may return to the New/Edit patient form by clicking on the RETURN TO PATIENT DETAILS button.
UNDERSTANDING THE ELIGIBILITY MESSAGE
The text message returned when you use the Check Eligibility feature appears as follows. An explanation of how to interpret the message appears in italics.
Checking eligibility for john doe .... PHN: 1234567890
NAME: JOHN DOE
BIRTHDATE: 19650412
GENDER: MALE
The first four lines confirm the correct spelling of the patients name, their birthdate, phn number and gender.
DOS: 20080925
ELIG_ON_DOS: YES
COVERAGE_END_DT:
COVERAGE_END_REASON:
DOS means Date of Service and the next line means Eligibility on Date of Service. YES confirms that the patient is currently insured for MSP benefits. If it says NO, then COVERAGE END DATE, would show the date the patient's benefits had stopped, and below that, the reason the patients coverage had ended.
PATIENT_VISIT_CHARGE: SERVICES PAID TO DATE 04
Or
PATIENT_VISIT_CHARGE: THIS IS NOT AN INSURED BENEFIT
This line confirms that the patient has premium assistance and is allowed a maximum of 10 visits to a supplemental practitioner. For acupuncture, physiotherapy, massage therapy or chiropractic treatment. The number shows the number of visits the patient has used this year.
If the patient is not covered for supplemental benefits, the message would read:-
THIS IS NOT AN INSURED BENEFIT
DATE_OF_LAST_EYE_EXAM: MSP HAS NOT PAID FOR AN EYE EXAM FOR THIS PHN IN THE LAST 24 MTHS FROM TODAY'S DATE
PATIENT_RESTRICTION: NO RESTRICTION
RESPONSE:
MESSAGE:
Additional information regarding patient restrictions or status, along with a notice for Optometrists stating the date of the patient's last eye exam is included in the last part of the message.
Please call our support line or email us at phoenixmedical@telus.net if you have any questions about using the Check Eligibility feature.
May 21, 2012 01:44:33
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