Pulling Benefits Electronically for Medical Payers
If you are using one of the approved clearinghouses for Uprise you can pull benefits electronically into Uprise. Pulling Electronic benefits is for Medical Insurance only. Trizetto requires the practice to pay them an extra fee to turn this feature on. Zirmed requires additional setup by Uprise. If you are a Zirmed customer please submit a case to request setup.
IMPORTANT: The patient's name and ID number have to match exactly with the information on file with the Insurance. If it is not an exact match, benefits will not be pulled.
1. From the Patient tab > Click Benefits dropdown
2. Select the medical insurance
3. Benefits window will open > Click New Benefit Request
4. Click Electronic > Enter the Begin/End Date for the Encounter
5. Select Eligibility > Select Service Type (most likely will be Medical Services)
6. Click Submit at the top right of the window
7. Once the eligibility is pulled you will be returned to the Benefit page. Double Click "Eligibility" to open the Benefit Details
8. Scroll down to find the Service type
9. Optional: You can also Click Print to view the details
10. If the benefits are pulled on the same day as the patient's appointment, the appointment will be linked to the results. You can also manually link the benefit to an appointment. Click the Action button > Click Link appointment
Linking the appointment will change the "M" on the appointment to Green.
10.1. Select the Appointment to link
10.2. The linked appointment medical/vision benefit can be viewed within the Scheduler Tab > Appointments Sub Tab – Medical/Vision Insurance Status. The red icon indicates that there is not a Medical/Vision Payer benefits associated with the appointment while the green icon indicates that there is one.
Example of an appointment without linked benefits.
Example of an appointment with linked benefits.
