Verify patient eligibility

Health Plans: 

  • The Health Plan

Workflow: 

  • Eligibility and Benefits

To verify eligibility for The Health Plan members, you must have the patient's member ID.

  1. Sign in to NaviNet. On the Health Plans menu, click The Health Plan
  2. Under Workflows for this Plan, click Eligibility and Benefits Inquiry. The following screen appears:
  3. To find the patient, specify the following search criteria:
    • Member ID. Include the suffix, or the Medicare or Medicaid ID. All letters must be uppercase.
    • Date of service. Choose a date up to one year in the past, or up to 30 days in the future.
  4. Click Search. If more than one patient matches your criteria, choose the patient from the list of matching patients.
    The following screen appears for the patient:
  5. To view coverage for a specific benefit type, for example physical therapy, click the benefit in the Benefits pane on the left side of the screen.

View, save, or print the member's ID card

To view a picture of the member's ID card, click Member ID Card in the Insurance Details section. The member ID card opens in a new window.
If you don't see the member ID card, ensure that your pop-up blocker is disabled.

  • To save a copy of the member ID card, right-click the card, and then click Save image as.
  • To print the member ID card, press Ctrl+P on a Windows keyboard, or Command+P on a Mac.

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