Insurance Eligibility Troubleshooting (in DrChrono)

If the Insurance Eligibility is not correctly loading in DrChrono, there are several possible errors, and ways to resolve them.

  • If the insurance is listed as inactive:This means the patient's insurance information is expired or otherwise out of date. The best way to get up to date information is to contact the patient directly. You can also check directly on the Insurance's provider portal to see if there is an updated insurance number.
  • If the Insurance is listed as "Inactive - Pending Eligibility Update":This typically means the insurance information on file has some error that is preventing DrChrono from correctly processing the information in the system. This can be caused by several different errors, and can then be resolved several ways. 
    • Go to the patient's profile, and click on the insurance tab.
      • Confirm correct Payer ID
        • Please compare the payer id listed to the payer id in the Valera Provider List.
        • If that is correct, and you have tried running the eligibility check again resulting in the same error, there may be an issue with the Patient's Member ID.
          • This can be verified in several ways (the links for all of these options can be found HERE):
            • Call the the patient directly.
            • Try the insurance's direct prover portal. (some will allow you to search for patients using other PHI)
            • Call the insurance's provider services line.

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