Eligibility Patient Demographic Query & Update

You can now complete a new or existing patient’s demographic information as part of an eligibility check in Lytec 2021. Once basic information for the patient has been entered into Lytec, performing an eligibility check will initiate a deposit of patient data into the existing Pending Patients feature. Then, you can update and import that information into the patient’s record.

Eligibility Information
• When an eligibility request is sent, it will use the current system date as it always has.
• The patient’s insurance carrier may or may not send complete demographic information back with the Eligibility Request. Each payer is different.

As part of this feature, several updates have been made in Lytec.

Updated Patients screen
There is a button on the Patients screen: Save and Query (also Ctrl + F9). Click this button to save a new patient’s record and initiate the eligibility request. Data that returns from your clearinghouse will populate the Pending Patients screen. You can then verify and modify the data and save it to the patient’s record.

The minimum required fields for performing an eligibility check are as follows:
• LAST NAME (from Patient Information tab)
• FIRST NAME
• MIDDLE NAME
• BIRTH DATE
• PRIMARY INSURANCE CODE (from Primary Insurance tab)
• INSURED ID NUMBER/MBI (from Primary Insurance tab)
• PROVIDER (from Associations tab)

eMDs recommends that you make these fields required for all new patient records.

Eligibility Check for Existing Patients
After the request completes, the eligibility results appear; and then when that screen is closed, the pending Patient screen opens.

When viewing the Pending Patients screen, data returned from the eligibility request that differs from existing patient fields will automatically populate/overwrite data on the left side.

On the left side Patient screen, changed data fields appear with a red field label and a red flag is on any tab where any data was updated. The right side displays the new values returned from the Eligibility request, as well as the previous values for reference.

Exceptions:
• If zip code+4 comes in as blank AND zip from the request returns a different 5 digit zip, the system will update the 5 digit zip and blank out the +4.
• If address 2 comes in as blank AND address 1 changed, the system blanks out address 2.
• For all other fields, the system will never overwrite a field with an incoming blank value. So if the request does not return a value, the system will not blank out a previously populated field.

Eligibility check for new patient using the Patients screen

1. In Lytec, select Lists > Patient > Patients. The Patients screen opens.
2. Click the New or Cancel button depending on your setup.
3. Enter the required information for the new patient.
4. Click the Save and Query button. The eligibility request is initiated and the Eligibility
   Verification Results screen opens.

5. Close the Eligibility Verification Results screen. The Patient record and Pending Patients section open.

Changed data appears with a red field header and a red flag on tabs with changed data on the Patients screen on the left. The right side displays the new value and the previous value.

6. Review and update the data as necessary.
7. Click the Save button to save the updated record and close the Pending Patients section.
   Otherwise, click the Close button to leave the record without saving. A confirmation window will appear to verify you wish to close without saving.

Note: if the Pending Patient results are not saved, they will not appear in the Pending Patient list to be worked later like other Pending results from a Mobile Intake do. However, you can later import the pending demographics using the new Import Demographics feature

Updated Insert/Edit Appointment Screen
There is a new button on the Insert/Edit Appointment screen: Save and Query. Clicking this button enables you to perform an eligibility verification for a patient while creating the appointment. This option will speed up the process of entering a new patient and checking that patient’s eligibility.

Scheduling an appointment for a new patient and performing an eligibility check

1. On the Lytec Scheduling menu, select Schedule Appointments.
2. On the Appointments screen, right-click an empty time slot and click Insert. The Insert Appointment screen opens.
3. Click the magnifying glass on the Patient Chart field. The Find Patient screen opens.
4. Click the Add button. The Quick Add – Patient screen opens.
5. Fill out the information on the screen and click the OK button.
   Note: listed above is the minimum required information to save a patient record for eligibility checking. eMDs recommends that you require complete information at this time.
6. Ensure the new patient is highlighted on the Find Patient screen and click the OK button. The new patient’s information populates the Insert Appointment screen.
7. Click the Save and Query button. The eligibility request is initiated and the Eligibility Verification Results screen opens.
8. Close the Eligibility Verification Results screen. The Patient record and Pending Patients section open.
   Changed data appears with a red field header and a red flag on tabs with changed data on the Patients screen on the left. The right side displays the new value and the previous value.
9. Review and update the data as necessary.
10. Click the Save button to save the updated record and close the Pending Patients section.
    Otherwise, click the Close button to leave the record without saving. A confirmation window will appear to verify you wish to close without saving.

Updated Right-Click Menu
There is a new option on the right-click menu for the Appointment scheduler: Patient Demo Quick Query. Selecting this option for an existing appointment will perform an eligibility check for the patient and send additional demographic data back to Lytec to update the patient’s record.

1. On the Appointments screen, right-click an appointment and select Patient Demo Quick Query.
2. The eligibility request is initiated and the Eligibility Verification Results screen opens.
3. Close the Eligibility Verification Results screen. The Patient record and Pending Patients section open.
   Changed data appears with a red field header and a red flag on tabs with changed data on the Patients screen on the left. The right side displays the new value and the previous value.
4. Review and update the data as necessary.
5. Click the Save button to save the updated record and close the Pending Patients section.
   Otherwise, click the Close button to leave the record without saving. A confirmation window will appear to verify you wish to close without saving.

Updated Eligibility Verification Results Screen
There is a new button on the Eligibility Verification Results screen accessed from the patient or from the main View eligibility results from the toolbar/ribbon: Import Demographics. Use this button to import patient demographic information from a previous, on-file eligibility result, without having to initiate a new eligibility request.

If the selected result was performed using an earlier version of Lytec, you will receive an error message. This feature only works for results performed using Lytec 2021.

Patient information will appear in the Pending Patients section of the Patients screen and you will edit it and save it as you would other Pending patient information.

1. On the Lists menu, select Patient and then Patients. The Patients screen opens.
   If you access Eligibility Results Verification from the menu/ribbon, select View Eligibility Results and proceed to step 4.
2. Select the patient from the Lookup.
3. Click the Patient drop-down on the right and select Eligibility Verification. The Eligibility Results Verification screen opens.
4. Select the previous result that you want to use to update the patient record.
5. Click the Import Demographics button. The Patient screen opens with Pending Patient information on the right.
6. Review and update the data as necessary.
7. Click the Save button to save the updated record and close the Pending Patients section.
   Otherwise, click the Close button to leave the record without saving. A confirmation window will appear to verify you wish to close without saving.