The NaviNet Open Eligibility and Benefits workflow lets you find and view patient eligibility and benefit details quickly and easily.
Accessing Eligibility and Benefits
Eligibility and Benefits is available under Workflows For This Plan on the Plan Central screen.
Patient Search Screen
- The Patient Search screen can now be customized by the health plan.
- The standard search screen is shown below, but you might see other fields depending on the health plan’s configurations.
- All fields are required unless marked “Optional.”
- The data you enter here is preserved so if you navigate back to this screen through the Wayfinder, you must clear and replace the data to start a new search.
Eligibility and Benefits Details Screen
The Eligibility and Benefits Details screen has been updated and includes the following enhancements:
- The View Patient Details link opens the Patient Details window, which provides additional patient demographics.
- The Print link allows you to print the information on the E&B Details screen.
- Secondary insurance information, if available, is displayed on additional payer tabs.
- A member’s eligibility status is displayed in a colored status bar.
- The Benefits menu displays a list of services supported by the health plan.
- The Details section displays primary and secondary benefits information for the patient, including copay, coinsurance, and deductible details, for the service chosen in the Benefits menu.
- Show Detail links allow you to view both annual and remaining deductible information, if available.
- If enabled by the health plan, the Additional Benefits link provides access to additional member benefits information.