Patient Onboarding & SchedulingPurpose
1.2. Authenticate insurance status, co-payment, out-of-pocket estimates, and authorization needs before confirming appointment, reducing claim denials and patient friction.
1.3. Eliminate manual data entry, minimize errors, and synchronize insurance data with EHR/EMR, patient communications, and scheduling tools.
Trigger Conditions
2.2. Admin enters patient demographic and insurance data into practice management system.
2.3. API/webhook event when patient record is created or updated in CRM or EMR/EHR system.
2.4. Time-based trigger (e.g., nightly batch insurance checks for next day appointments).
Platform Variants
• Feature/Setting: Configure Process Builder or Flow to trigger insurance lookup upon new patient record, utilizing Health Cloud’s prebuilt insurance integration API.
3.2. Athenahealth
• Feature/Setting: Automate eligibility API calls in patient onboarding workflow, mapping payer IDs and tailoring response handling.
3.3. Epic Systems (App Orchard API)
• Feature/Setting: Enable real-time eligibility verification via FHIR/HL7 interfaces on patient intake.
3.4. Cerner Millennium
• Feature/Setting: Integrate PowerChart insurance verification module, using HealtheIntent APIs for eligibility checks.
3.5. eClinicalWorks
• Feature/Setting: Set up eBO reports and custom triggers to auto-run insurance eligibility checks tied to registration events.
3.6. Kareo
• Feature/Setting: Use Kareo API for eligibility status fetch in registration automation flow.
3.7. NextGen Healthcare
• Feature/Setting: Link patient intake API to NextGen’s eligibility verification service via workflow automation.
3.8. Availity
• Feature/Setting: Call Availity Real-Time Eligibility & Benefits (270/271 EDI) API initiated by new appointment creation event.
3.9. Change Healthcare
• Feature/Setting: Configure Real-Time Eligibility API to respond to triggers from EHR or scheduling system.
3.10. Redox
• Feature/Setting: Integrate Redox eligibility API, listening for new patient submission event and transforming data to payer format.
3.11. Intergy (Greenway Health)
• Feature/Setting: Schedule automatic eligibility check during pre-registration through Intergy workflow engine.
3.12. Health Gorilla
• Feature/Setting: Connect to Health Gorilla Insurance Data APIs, auto-launch verification on intake completion.
3.13. Experian Health
• Feature/Setting: Set up API triggers for Coverage Discovery on patient registration.
3.14. Practice Fusion
• Feature/Setting: Automate eligibility lookups via third-party API connection when new patient profile is created.
3.15. DrChrono
• Feature/Setting: Use Webhooks/API to invoke insurance eligibility module upon intake form submission.
3.16. AdvancedMD
• Feature/Setting: Link scheduling events to AdvancedMD Insurance Eligibility service using internal automation tools.
3.17. Meditech
• Feature/Setting: Configure task-based insurance verification leveraging Meditech’s application scripting.
3.18. Surescripts
• Feature/Setting: Invoke Surescripts Eligibility & Formulary API following insurance field entry in onboarding flow.
3.19. HL7 Integration Engine (e.g., Mirth Connect)
• Feature/Setting: Create channel to transform onboarding data to HL7 270, transmit to clearinghouse for eligibility.
3.20. Tebra (formerly Kareo + PatientPop)
• Feature/Setting: Join scheduling/onsite registration triggers to Tebra's API for seamless eligibility status sync.
Benefits
4.2. Accelerate patient onboarding, minimizing appointment scheduling delays.
4.3. Decrease insurance-related billing errors and claim denials.
4.4. Enhance patient transparency on coverage, co-pays, and next steps.
4.5. Ensure payer compliance and streamline staff workflow.
4.6. Improve patient satisfaction and reputation of the Allergy & Immunology practice.