Released 9/24/25
In the PDF document that contains response data from an eligibility request, there is now a summary of the eligibility information that is specific to a patient’s appointment so you don’t have to search through the entire document to find eligibility information for the services related to the appointment.
With an Eligibility Essentials or Pro subscription, when an eligibility request (automatic or manual) successfully returns either standard or enhanced data, a summary section titled “Appointment Coverage Details” now appears at the top of the PDF document.
This new section includes the procedure codes from the appointment and the following related benefit details:
- The Coinsurance (coverage percentage) and/or Copay (amount)
- Age Limitation
- Frequency Limitation
- Waiting Period
- Benefit Notes (There is an icon like the one that exists currently in the HTML if a benefit note was received for a specific procedure code. If there is a benefit note associated with a code from the appointment, include it with the appointment in the summary).
Notes:
- If no information is returned for any of the benefit details, “–” appears.
- If there are multiple appointments for a patient, the procedures in the summary section are grouped chronologically by appointment date and time.
- If a procedure code is associated with an appointment multiple times, in the summary section, the procedure appears only once for that appointment.
- Information for up to five appointments can appear in the summary section.
Sample – single appointment
Sample – multiple appointments
