One Body provides US-based clinics with a simple way to check patient insurance eligibility and coverage with the click of a button. The following describes how to set it up in Practice Perfect.
Payor Setup
Every Payor has a unique Identifier number that is generally universal. Click here to view a spreadsheet containing these Payor Identifier numbers.
The Identifier number can be entered in one of two places:
1) In the Payor profile in the Identifier field.
2) In Settings>Customize One Body>Payors.
The number entered here will override whatever you may have entered in the Payor profile, in case One Body requires you to use a different Identifier number.
Provider Setup
Several fields must be completed for your Providers, as well. There are two screens in which these fields must be completed.
1) In Settings>Customize One Body>Providers, you must enter a Provider Type for each Provider.
2) In Housekeeping>Contacts>Providers, the following fields must be completed: Work Phone Number, Work Email, NPI Number.
Please note that some Payors, such as Medicare and Medicaid, require the Provider’s Social Security Number (SSN), as well.
Checking Eligibility
In the Client Profile, first ensure that the Client has either a Primary Provider or a Billing Provider in their Incident. In the event that both fields are filled in, the system will use the Billing Provider to run the check.
Then navigate to the Policy/Claim tab. Click the Insurance Eligibility button to run the check.
The following dialogue box will appear.
After 20 seconds, if we’ve yet to fetch the data from One Body, this box will appear.
Click Yes to continue waiting. Clicking No will abort the process.
Once the eligibility data has been fetched, your web browser will open to a page like this. An AI generated summary of the client’s coverage and benefits will be found at the top, with a more detailed breakdown below.
In some cases, if the provider hasn’t been registered with a certain insurance carrier, you may receive the following message. This happens most often with Medicare and Medicaid.
It can take the insurance carrier a couple days to verify the provider on the back end, so continuing to wait won’t work. In these cases, you will receive an email once the Provider has been approved in their system, and you may resume running checks for them, as normal.
Fee Schedule
$1.00 per successful information return
$0.50 charge if the patient could not be located due to incorrect policy information