The Eligibility page is comprised of three tabs:
It is used to perform administrative functions pertaining to Eligibility functions in Connect.
Configuration Tab
The Configuration tab is used to define Enterprise and Practice Level rules pertaining to Eligibility and Case Hold automation.
Payer Mappings Tab
The Payer Mappings tab allows clients using a clearinghouse other than TriZetto to map their payers to TriZetto Payer IDs so they can utilize Eligibility functionality in Connect.
From this page, you can view your full list of payers/plans mapped to their corresponding TriZetto Payer IDs.
The page also provides, at a glance, information on which payers require additional enrollment.
Excluded Payers Tab
The Excluded Payers tab is used to identify Payers, as well as Payer/Plans and Payer/Practice combos, to be excluded from Eligibility checks.
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Field DefinitionsEligibility / Eligibility / Configuration Tab Eligibility / Payer Mappings Tab Eligibility / Excluded Payers Tab Step-By-Step Guides |