Here are a few tips to consider when running an eligibility search for patients based on the vision portal:
VSP
Required to search by the primary member
Search by Name, DOB, and Last 4 of SSN and/or Member ID#
If a member has a unique Member ID#, you are required to use that instead of the last 4 of SSN
You can search by member id# only, and Aloha will only search for a result in VSP
To pull eligibility and benefit information in VSP, we create an authorization for the entire family, pull the eligibility and benefits, then immediately remove that authorization so there are no outstanding authorizations held for the family
To pull an authorization for a member, click on the authorization button and then check the box of the member you would like to pull the authorization for
Authorizations are pulled for all services and materials
Results are pulled for the primary as well as all dependents
EyeMed
Not required to search by primary member
You can search by any family member to pull results for the entire family.
Search by Name and DOB
Search by Member ID# only
Results are pulled for the primary as well as all dependents
Aetna- EyeMed
Required to search by the primary member
Search by Name and DOB
Click on Add Dependent Patient Information to search for additional members
Future eligibility searches will include results for all added members
Spectera
Not required to search by the primary member
You can search by any family member to pull results for the entire family.
Search by Name and DOB
Search by Member ID# only
Results are pulled for the primary as well as all dependents
Davis
Required to search by each individual member
Search by Name and DOB
Click on Add Dependent Patient Information to search for additional members
Future eligibility searches will include results for all added members
Superior
Required to search by each individual member
Search by Name and DOB
Click on Add Dependent Patient Information to search for additional members
Future eligibility searches will include results for all added members
NVA
Not required to search by the primary member
You can search by any family member to pull results for the entire family.
Search by Name and DOB
Search by Member ID# only
Results are pulled for the primary as well as all dependents
Existing Patients in Aloha
Once a patient has previously been searched in Aloha, you can type in their name in the Eligibility Search bar and it will filter all patients by the information inputted
This could be first name, last name, DOB, or any individual criteria input
*Click on the "Refresh Eligibility" button to automatically run eligibility and refresh benefits for the applicable members
Eligibility Results
All eligibility results expire after 48 hours
This ensures that if staff are accessing a patient’s eligibility, they always will have the most up-to-date version of that patient’s eligibility