Checking Patient Eligibility

Performing an eligibility check on patients before they are seen ensures that the services your clinic is about to provide can be successfully paid for by your province or billed privately if the patient is currently not covered by a provincial plan. If you are practicing in Ontario or British Columbia and are successfully connected with GoSecure or Teleplan, you can perform eligibility checks directly within your EMR.

Eligibility checks can be initiated from the patient’s details page (Juno UI) and master file (Classic UI) or from the invoice creation page in ClinicAid. See our guides below for more information on each of those methods.

Details Page – Juno UI

Access the patient’s Details page. This can be done by using the Search tools, clicking on the ‘M’ on an appointment, or navigating to the ‘Details’ tab of their chart after accessing the record’s ‘Summary’.

At the top of the page, locate the ‘Check Eligibility’ button and click on it. An overlay will appear underneath the button with details on the eligibility check and its result. 

Master File – Classic UI

Access the patient’s Master File. This can be done by using the Search window, clicking on the ‘M’ on an appointment, or on the patient’s name at the top of the eChart among other ways.

Towards the top left of the page, locate the ‘Check Eligibility’ link and click on it. An overlay will appear underneath the link with details on the eligibility check and its result.

ClinicAid

You can also check eligibility for your patients on the ClinicAid invoice creation window. Access the invoice creation window by clicking on the ‘B’ on an appointment or using the ‘Create Invoice’ option from either the Details page or the Master File.

Locate the ‘Patient Information’ section on the right-hand side of the page. On the section header, you will find a person icon. There are three primary colors to look for:

• A green icon means the patient is eligible for provincial coverage.
• A red icon identifies the patient is not eligible for provincial coverage.
• A white icon identifies that the eligibility check was not run.

The icon may also appear in other colors. To find more details about the check, hover your cursor over the icon. This will give you the same information as the overlay when performing an eligibility check within the EMR itself.

If the check did not run and you would like to run it in ClinicAid, simply click on the icon itself and await results.

Running Into Problems?

If you are unable to run eligibility checks, verify that your GoSecure or Teleplan credentials are up to date. Eligibility checks run through the provincial platform. If you cannot connect to it due to erroneous or expired credentials, you will not be able to check your patients’ eligibility.

If your credentials are correct, GoSecure or Teleplan’s system may be down. Outages on their system is the primary cause of difficulties with eligibility checks. Not being able to access the platform’s website or being unable to login is usually a good indication that there are issues on their side. 

If everything appears to be working but you are still running into difficulties, do not hesitate to contact our team.