Eligibility Module

Email Notifications

Email notifications for eligibility status provide automated, real-time updates on coverage changes and status updates. This helps users stay informed, reduce manual follow-ups, and improve workflow efficiency in eligibility management.

Future Checks

Future eligibility checks allow users to view whether a consumer’s eligibility is scheduled to terminate at a later date. This provides visibility into upcoming coverage changes, helping teams plan ahead with confidence and avoid providing services to ineligible consumers.

Monitor MCO Switches

MCO switch monitoring enables users to identify when a consumer changes managed care organizations. This provides visibility into coverage transitions, helps maintain accurate eligibility records, and ensures providers bill the correct payer for services rendered.

Alert Dashboard

The alerts dashboard provides a centralized view of key eligibility activity, including MCO changes, eligibility alerts, and status updates. This consolidated visibility helps users quickly monitor results and stay informed without navigating multiple areas of the system.