Eligibility Recommendations

The Chiron Rules engine runs an eligibility check on all appointments. Eligibility determinations can be found in the “Billing Details” section of the platform. To verify eligibility, please follow the following steps:

1
From the home screen, click on “Switch to Detailed View”
2
Fill in the “FILTER BY” filter or use the “Sort by” drop down to view future appointments

3
Finally, eligibility can be found in the “Payer Type” column of each appointment:  
  • Eligible plans are marked with a green checkmark- no further action is required.

  • Ineligible plans appear in yellow text- the ineligible status appears when a patient is not eligible for telemedicine services. We recommend notifying the patient that his or her insurance is ineligible for telemedicine services.

  • Indeterminable plans also appear in yellow text- the indeterminable status appears when Chiron is unable to connect with the insurance company, the information the patient entered is invalid, the Providers NPI was not entered or we have determined that the patient's policy is not clear on originating site rule or allowable services. We recommend that you attempt to contact the payer, otherwise, the appointment defaults to a self- pay rate. 

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