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All CollectionsAloha (Formerly PracticePal)
Eligibility Search Tips
Eligibility Search Tips
Caleb Pilarski avatar
Written by Caleb Pilarski
Updated over 3 months ago

Here are a few tips to consider when running an eligibility search for patients based on the vision portal:

VSP

  1. Required to search by the primary member

  2. Search by Name, DOB, and Last 4 of SSN and/or Member ID#

    1. If a member has a unique Member ID#, you are required to use that instead of the last 4 of SSN

  3. You can search by member id# only, and Aloha will only search for a result in VSP

  4. 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

  5. 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

  6. Authorizations are pulled for all services and materials

  7. Results are pulled for the primary as well as all dependents

EyeMed

  1. Not required to search by primary member

    1. You can search by any family member to pull results for the entire family.

  2. Search by Name and DOB

  3. Search by Member ID# only

  4. Results are pulled for the primary as well as all dependents

Aetna- EyeMed

  1. Required to search by the primary member

  2. Search by Name and DOB

  3. Click on Add Dependent Patient Information to search for additional members

    1. Future eligibility searches will include results for all added members

Spectera

  1. Not required to search by the primary member

    1. You can search by any family member to pull results for the entire family.

  2. Search by Name and DOB

  3. Search by Member ID# only

  4. Results are pulled for the primary as well as all dependents

Davis

  1. Required to search by each individual member

  2. Search by Name and DOB

  3. Click on Add Dependent Patient Information to search for additional members

    1. Future eligibility searches will include results for all added members

Superior

  1. Required to search by each individual member

  2. Search by Name and DOB

  3. Click on Add Dependent Patient Information to search for additional members

    1. Future eligibility searches will include results for all added members

NVA

  1. Not required to search by the primary member

    1. You can search by any family member to pull results for the entire family.

  2. Search by Name and DOB

  3. Search by Member ID# only

  4. Results are pulled for the primary as well as all dependents

Existing Patients in Aloha

  1. 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

    1. 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

  1. All eligibility results expire after 48 hours

    1. 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

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