View Copay Summary on Payer-Provided Eligibility Details Page

What's New

If you're using the enhanced Payer-Provided Eligibility Details page (released in Summer 2023) , you can now use the new Copay Summary tab to find patient copay details more easily and quickly.

Previously, patient copay information could be difficult to find because it was only included on the Service Types tab among a variety of other benefit coverage details.

Now, patient copay information is summarized on a separate tab, making it easier to find for workflows such as Check-in and Time of Service collections.

Note: The copay information will still also be in the Service Types tab along with other benefit coverage details.

New Copay Summary tab:

Tip: Hover over the image to see an expanded view

We're making this change because you requested it. Keep those suggestions coming!

Timeline for the new eligibility experience

As you may know, we rolled out an enhanced eligibility experience in the Summer 2023 Release that consolidated multiple workflows into a simplified, comprehensive Payer-Provided Eligibility Details page.

• The new experience provides more information in fewer clicks and scrolls, which can improve not only user efficiency and satisfaction but also help get your organization paid more quickly.
• Check out the O-help article for more details.

You’ve had the option to set the new Eligibility Details page as your preferred default experience, or to maintain the legacy experience as a default.

We understand that some users have gone back to the legacy eligibility pages due to performance issues or a lack of feature parity. Based on your feedback, we've released updates to improve performance and usability. We also plan to release additional enhancements in future releases.

Setup instructions

No action is needed to enable this feature but you must be using the enhanced Payer-Provided Eligibility Details page to see this functionality.

To view patient eligibility Copay Summary

1. Display the Payer-Provided Eligibility Details page for a patient using one of these workflows:

   • On the Patient Actions Bar, click Registration > Check Eligibility. If the patient has only one policy registered in athenaOne, the Payer-Provided Eligibility Details page appears.
   • On the Quickview page, under the Insurances heading, click the View eligibility detail and history link.
   • On the Quickview page, under the Insurances heading, click the Perform Custom Eligibility Check link and then select the options for the custom check.
   • On the Add/Update Policy Details page, click the View eligibility detail and history link.

   • On the Add/Update Policy Details page, click the Update & Perform Eligibility Check button.

   • On the legacy Eligibility Detail page, click the Switch to new eligibility details page link.
    

   The Payer-Provided Eligibility Details page appears.

   
   

2. Status - DOS — Select a Date of Service for the patient's Eligibility details. The information in the header and in all the tabs will change based on the Date of Service you select.
   

   Click the Copay Summary tab.

    

   The page displays the following copay details received from the payer:

    

   Payer-provided Eligibility Details — Copay Summary tab
   Field name	Description
   Service Type	The Service Type for benefit coverage.   The ordering of Service Types listed within the Copay Summary tab will reflect the "favorites" you selected on the Service Types tab.   Coming soon! The expand/collapse icon appears if multiple Service Types are listed within a Service Type category.
   Copay	The copay amount (per Visit or per Day) for the service type.
   Network	The provider's network status (In, Out, Either).
   Payer Messages	Messages returned by the payer in the eligibility response, if any.
   Date of Service	The date of service for the eligibility check.   Use the Status - DOS selector in the header to see copay summary for another date of service.