The Eligibility Department responds to your request for eligibility verification by sending a message to your Inbox.

Member
The name of the patient whose eligibility is being verified.

Date
The date the request was submitted.

Subject
Verification completed.

This message indicates whether or not the patient is eligible and includes an explanation for the determination.

Request ID
A system-generated number.

Patient Eligible
YES or NO

Resolution Type
These are the options:

Member effective with BT
Member effective with another IPA (see Notes)
Health plan could not identify member with ID#/SSN provided
Member effective with another PCP within BT (see Notes)
Member term BT and health plan
New born not added to HMO plan. Covered under mom for the 1st 30 or 31 days only
Member not effective with BT on DOS (see Notes)
Member had a non HMO plan at the time of service
Dependent of a dependent - not covered
Third trimester - not eligible
Dual coverage updated in IDX
Member term BT
PCP assignment verified with health plan updated in IDX
Need Medicare effective date
Duplicate MRN corrected IDX updated
Employer group/plan information updated (see Notes)

PCP
Patient's current Primary Care Physician.

Effective Date
Date the patient became effective with the health plan.

Termination
Date the patient was or will be terminated.

Final Remarks
Notes or comments from the Eligibility Department.