Insurance Eligibility Tracker

Osmind One's Insurance Eligibility Tracker is an (optional) setting that enables you to keep track of critical insurance information related to a particular patient's insurance coverage. This can be useful in understanding how many visits are approved for reimbursement, and how many have been utilized during a specific time period, to help manage and predict likelihood of insurance coverage for a particular patient. Additionally you can keep track of a required referral, and indicate that a referral has been obtained for a patient.

For additional automation of workflow, the Insurance Eligibility Tracker is connected to Osmind One's Calendar, and the number of visits used and number of visits remaining will automatically update based on a patient's scheduled and occurred appointments.

In this article

• Enable the Insurance Eligibility Tracker

• Add information for a particular patient (benefits details, reference details, call reference numbers, and more)

• Keeping track of available visits

• Automations with regards to expired sessions

• Integrations with third-party Insurance Eligibility Check Providers

Enable the Insurance Eligibility Tracker

If you would like to use the Insurance Eligibility Tracker in your practice, navigate to Gear Icon (top-right of account) > Settings > Insurance

A side panel drawer will appear containing a list of insurance-related settings that you can enable/disable for your account.

Enable Track Patient Insurance Eligibility

This setting will display on each patient's profile and includes fields for an authorization number, number of visits, start and stop date, visits used, and visits left. For providers, this will allow you to diligently keep track of your patient's insurance benefits.

Add information for a particular patient

If you would like to add information that you have received from an insurance company to your Patient's Profile, navigate to Patient Profile > Overview > Insurance Authorization > Edit > Add information

You can also manually add an insurance policy (including a secondary or inactive policy) to your patient's account within their profile.

Insurance Eligibility & Prior Authorizations

Once your patient's insurance information has been added into Osmind One, you can then update their Insurance Eligibility details. Return to the overview page of their patient profile > Insurance Eligibility > Edit Eligibility.

Select the box Insurance Authorization Required

You will be then prompted to enter information including a patient's authorization number, # of authorized visits approved for a patient, # of authorized visits used, and effective start / end date.

Benefits Information

Within the eligibility section of your patient's profile, you can add details around your patient's benefits. You can add multiple sets of information, for Preventive and/or Medical benefits.

• Indicate if your patient has telehealth coverage

• Copay amount ($)

• Coinsurance amount (%)

• Deductible for the calendar year ($)

• Deductible used year-to-date ($)

Coverage

Add details related to conditions and services that are covered under your patient's insurance plan.

• Covered CPT codes

• Covered ICD-10 codes

Referral Details

Additionally, you can indicate if a referral is required/not required for this patient. You can return to this section to update whether a required referral has been obtained (or not).

When you press "Save" you are then able to view this information within the Patient's profile. If you have a session occur with the patient, this insurance eligibility tracker will automatically update to reflect the reduction in remaining sessions available. You are always able to override this by editing the section directly.

Call Reference Details

Here you can add the specific reference number, the date & time, and any relevant notes. At this time, you can only add ONE call reference for each patient plan. A forthcoming update will allow you to document unlimited call reference numbers.

Keeping track of available visits for Prior Authorizations

When a patient is booked for any session, it will be deducted from "Visits Left" and added to "Visits Used." Currently, there's no option to limit this to specific appointment types—all scheduled sessions count toward visits.

However, if any appointments are marked on the calendar as Cancelled, No-Show, or Rescheduled, the visit will automatically be returned to the "Visits Left" tally.

The eligibility tracker will NOT deduct any past sessions from the moment it has been activated. If your patient has already used authorized visits, prior to the tracker being enabled, we suggest that you manually adjust the number of visits accordingly.

Automations with regards to expired sessions

If sessions have expired, Osmind One's Insurance Eligibility Tracker will alert you that there were unused sessions.

Integrations with third-party Insurance Eligibility Check Providers

Osmind One integrates with third-party insurance eligibility check providers. These include options like Claim MD and others.