The Eligibility summary PDF is generated for each active insurance verification and typically includes coverage, co-pays, in and out-of-network coverages, and more. Patients’ Eligibility PDFs will vary based on the information each insurance provider makes available for electronic verifications. Some payers provide more benefits information, even down to the level of procedure code, deductibles, waiting periods, and exclusions. Other payers may only make the basics available, like the patient’s progress toward their deductible and copay amount.

While NexHealth will always return all the information we receive, we cannot guarantee the specific information each payer returns.

Here is a sample of the first page of an Eligibility PDF:

For integrated forms customers, the Eligibility PDF will automatically sync to the patient chart in the health record system. For customers without integrated forms, the summary can be downloaded from NexHealth and uploaded into the patient record.