Checking that a patient’s Private Health Insurance is current can be carried in from the List View, Calendar View and in the Client Record – Insurance section.
This verification only confirms that they are current with that Health Fund and does not confirm that they are covered for that procedure. You need to carry out an Online Eligibility Check (OEC) for this.
- Ensure that the Health Fund does an OEC.
- Check that this is flagged on the fund record in Contact Management - Insurers/Companies
- For this to work there must be a Medicare Expiry date entered on the Client Insurance tab (even though PVO does not return this date!)
OEC Workflow
Direct CONTROL is designed to generate the OEC from the IFC as certain detail is required for this to work correctly, being:
- Health Fund
- Provider
- Date of Service
- Principal Procedure
- Hospital
Generate the OEC from the IFC
- The IFC can be generated in a number of ways.
- Right-click on the List or Calendar View. If you have selected a Standard Procedure on the appointment form, the IFC will populate with this detail.
- Select IFC and OEC button in Client Insurance, or
- Go to Client Transactions and select IFC on the sidebar.
- With the IFC form open and populated with item codes and the principal procedure/item code is the first item, select OEC on the sidebar.
- This results in the OEC form opening populated with relevant detail.
- Select Accept and the OEC report will display on screen for you to print if you wish.
- The report is also saved as a PDF in Client Communications for future reference.