Undetermined Payment - "Undetermined" insurance status designates that a patient has insurance information that has not been verified for coverage or that an incorrect input has been updated to the patient profile. A patient’s insurance information on file will show as “undetermined” due to the following:
The patient's insurance coverage/policy has been incorrectly scheduled with the wrong insurance organization or employer wellness plan association.
The patient's insurance coverage/policy has been incorrectly scheduled with the wrong member ID or employer wellness plan information.
The patient's demographics input (ie. name, DOB, address) has been incorrectly input which does not match eligibility in the organization E-files.
The patient has scheduled themselves with the member ID, insurance policy, or employer wellness plan information that is valid and active for a different member (usually occurs with families, household members, and child/PED profiles).
The patient's insurance coverage/policy cannot be automatically confirmed with the profile input as per eligibility file information and needs a further review of coverage.
You can submit an eligibility ticket to ensure your member is covered with their current insurance.
Create an Eligibility Ticket here.