Payors that Allow Eligibility Checking

Though most payors allow automated eligibility checking, some payors do not. Users can only verify eligibility (in Patients | Intake / Referral | Insurance | Eligibility) for payors that allow eligibility checking through ABILITY.

By running the Payer Master Listing report available in firstREV, users can acquire a complete list of payors that allow eligibility checking through ABILITY. Additionally, this report includes a list of eligibility payor IDs, which can be used to create an eligibility payor ID override (in Master Files | Payors / Plans | Eligibility) if the claim payor ID differs from the eligibility payor ID.

Follow the instructions below to access the Payer Master Listing report:

1.    Navigate to Accounts | Billing and then click the firstREV tab.

2.    Using the toolbar, click Reporting and then select Reports.

3.    On the left side of the screen, click the Support folder.

4.    Click the CSV hyperlink in the Execute column. A confirmation prompt will display.

5.    Select the Click to download your report CSV option. The report will automatically open the file in Microsoft Excel.

6.    The G column, Elig - Payer ID, will display the payor ID that must be entered for the eligibility override.

●     If the eligibility payer ID column displays as “N/A”, this indicates that either ABILITY does not support eligibility checking for this payor or the payor does not support eligibility checking.

●     If the payor does support eligibility checking, but ABILITY does not, please contact HCF Support at 888-563-7016 to submit a request to set up this payor for eligibility checking.

●     Though it is not required to use firstREV in order to check eligibility, there may be cases where the payor requires eligibility enrollment. If the firstREV Payer Master Listing report displays “Y” in the Elig - Enrollment column, users must enroll within firstREV to check eligibility for this payor.