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GoRev Real Time Eligibility Tutorial

Welcome to the GoRev Real Time Eligibility Tutorial. In this tutorial, we will focus on the process of utilizing the Eligibility Module in GoRev.

1 : Navigating to the Patient Overview Module

As a GoRev User, the Eligibility Module will allow you to determine a Patient’s Insurance Eligibility in Real Time. To begin, please navigate to the Patient Overview Module of the required Patient using the Search area of the GoRev Homepage.

2 : Navigating to the GoRev Eligibility Module

At this point, the Patient Overview Module for the required Patient will appear on your screen. Now, in order to determine the Patient’s Insurance Eligibility in Real Time, first, begin by clicking on the “Eligibility” button located in the Office section of the Patient Overview Toolbar.

3 : Navigating to the "Electronic Eligibility Request" Window

After the “GoRev Eligibility” window becomes visible, please click on the “Real Time Eligibility” button present on your device.

4 : Analyzing the "Subscriber Information" Section

At this point, the “Electronic Eligibility Request” window will appear on your screen. The “Electronic Eligibility Request” window is comprised of four sections. In the first section, titled “Subscriber Information”, you will find the appropriate Guarantor Information for this Patient Account.

5 : Locating the "Insurance Information" Section

In addition to the “Subscriber Information” section, the “Electronic Eligibility Request” window, also, contains a secondary section, titled “Insurance Information”. In this section, you will find the “GoRev Carrier”, the “Clearinghouse Payer”, the Patient’sMember ID”, and the “Group Number”.

6 : Defining the "Clearinghouse Payer"

As a default, the “Clearinghouse Payer” field will be auto-filled. However, if this field is blank, please define the Clearinghouse Payer for this Patient Account. To begin, please search for the required Clearinghouse Payer by entering the Payer’s Name or ID into the corresponding field provided.

As you are entering this information, existing Clearinghouse Payers will appear below the field that you are filling. Once you locate the correct Clearinghouse Payer, please use the arrow keys to highlight this Payer and hit “Enter” on your keyboard.

7 : Analyzing the "Patient Information" Section

In addition to the “Insurance Information” section, the “Electronic Eligibility Request” window, also, contains a third section, titled “Patient Information”. In this section, you will find the Patient’s Name, Social Security Number, and their Relationship to the Insured.

8 : Analyzing the Additional "Insurance Information" Section

Lastly, the “Electronic Eligibility Request” window contains a fourth section, which is, also, titled “Insurance Information”. In this section, you will find the Patient’sDate of Service”, the “Visit Location”, and the appropriate “Procedure Codes” for this Visit.

9 : Including CPT Codes in the Eligibility Request

If you would like to include CPT Codes in your Eligibility Request, please enter the appropriate CPT Code into the “Procedure Codes” field in this section.

Additionally, in the event that you need to enter multiple CPT Codes for this Patient, please separate each CPT Code with a comma.

10 : Submitting the Eligibility Request

Now, in order to submit the Eligibility Request, please click on the “Run Eligibility” button present in the bottom right corner of this window.

11 : Responding to an "Operation Failed" Window

In the event that an “Operation Failed” window appears on your device, please read the error description present in this window and correct any errors pertaining to the Patient’s Account.

If you are unable to correct an error, please submit an IT Support Ticket by using the “Submit Ticket” button in this window.

12 : Analyzing an Inactive Status Result

At this point, the Results of the Eligibility Request will be present on your screen. Eligibility Requests result in either an Active or an Inactive Status. An Eligibility Request will result in an Inactive Status if the Patient’s Insurance Coverage was identified but is Not Active for the specified Date of Service. As a default, an Inactive Status will cause the GoRev Eligibility Status field to appear red.

13 : Viewing the Detailed Eligibility Status Response for the Inactive Status Result

Now, in order to view a more detailed Eligibility Status Response, please click on the “Eligibility Response” link in this window.

14 : Beginning the Save Process

At this point, the detailed Eligibility Response will open in your computer’s default web browser. In the event that you would like to Save a copy of this response to GoRev’s File Management System, please begin by closing the Eligibility Response window.

15 : Saving the Response to the File Management System

After the window has closed, please click on the “Save Changes” button present near the bottom of the “GoRev Eligibility” window.

Utilizing the “Save Changes” button will cause a PDF File of the Eligibility Response to be saved into the File Management section of the Patient Overview Module.

16 : Analyzing an Active Status Result

In opposition to an Inactive Status, an Eligibility Request will result in an Active Status if the Patient’s Insurance Coverage was identified and is Active for the specified Date of Service. As a default, an Active Status will cause the GoRev Eligibility Status field to appear green.

Additionally, if the Patient’s Insurance Coverage is Active, the fields in the “Patient Responsibilities and Deductible” section of this window will be auto-filled.

17 : Viewing the Detailed Eligibility Status Response for the Active Status Result

Now, if you would like to view a more detailed Eligibility Status Response, please use the “Eligibility Response” link on your screen to complete this task.

18 : Saving the Eligibility Request Response

Furthermore, if you would like to Save the Eligibility Request Response to the File Management System, please use the “Save Changes” button in this window to save the response.

Additional Resources

GoRev Real Time Eligibility Video Tutorial

GoRev Support Team

If you have any additional questions or concerns regarding the process of utilizing the Eligibility Module in GoRev, please contact the GoRev Support Team at (1-(832)-658-2209).

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