Patient insurance eligibility

The eligibility and coverage fields Elation Billing tracks - eligibility status and check date, Medicare code, and the coverage window - that the patient_insurance policy record does not carry. Join back to patient_insurance via patient_insurance_id for the policy itself (member id, group, rank, subscriber demographics). This table’s columns and relationships are shown in the Hosted Database schema.

patient_insurance_id is null for the small share of Elation Billing insurance records that do not map to an EHR patient_insurance row; patient_id is always set and can be used to attribute those records to a patient.

For reporting on but not limited to:

Current insurance eligibility status and when it was last verified
Coverage start and end dates for a patient’s insurance
Which insurance record is the current one on file (versus superseded or deleted)
Medicare Secondary Payer value codes

Current insurance eligibility and coverage for a patient

select
    pie.patient_id
  , p.full_name
  , pi.carrier
  , pie.coverage_start
  , pie.coverage_end
  , pie.eligibility_status
  , pie.eligibility_date
from patient_insurance_eligibility pie
  left join patient p on p.id = pie.patient_id
  left join patient_insurance pi on pi.id = pie.patient_insurance_id
where pie.is_active          -- the current, non-superseded record (not "coverage in effect")
  and not pie.is_deleted;

If you have any questions about this topic please reach out to Elation Support Portal with the subject line HDB - <your_question>

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Current insurance eligibility and coverage for a patient

​Current insurance eligibility and coverage for a patient

Current insurance eligibility and coverage for a patient