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Working with Insurance Discovery Results

Once a discovery search finishes, you can open it to review what was found and decide what to do next. This article covers the Discovery Details page and the actions available on it.

 Open a discovery

Go to Insurance Discovery in the left navigation and click a name in the list. The Discovery Details page opens.

The header shows the person's name, the coverage result, the payer name, a reference number, and the insurance status.

What you'll see on the details page

Plan and coverage information

  • Name, date of birth, age, client type, and facility
  • Insurance company
  • Member ID and group number
  • Subscriber relationship
  • As of date and coverage
  • Reference number

Patient and subscriber information

  • Patient name and subscriber name
  • Subscriber relationship
  • Member ID
  • Address

Some fields may be blank, depending on what the payer returned.

System information

  • Discovery ID and request duration
  • Created by and created date
  • Last updated by and last updated date
Actions on the details page

Edit

Opens the Update Discovery Details window, where you can change the first and last name, date of birth, Social Security number, gender, phone numbers, address, city, postal code, state, and current client status.

  • Save updates the stored details only. It does not use a credit.
  • Save and Discover updates the details and searches again. It uses a new Insurance Discovery credit.

Re-Discover

Runs the search again using the saved information. It uses a new Insurance Discovery credit. The results update on the same discovery rather than adding a new row to your list.

Save as PDF

Exports the visible discovery details to a PDF, including the name, payer, coverage status, reference number, member ID, group number, and patient and subscriber information. PDFs contain patient and insurance information, so store and share them according to your organization's privacy policies.

VOB

Starts a standard Verification of Benefits from the discovery. The New Verification window opens with the information we already know filled in. You will need to select the payer yourself before you can run the verification, so choose the payer that matches the coverage that was found.

See How to Run a New Verification (VOB) for the rest of the steps.

Delete

Removes the discovery from your main Insurance Discovery list. It is not permanently erased. To see it again, set the Archive filter to Yes on the Insurance Discovery list.

Duplicate discoveries

If another discovery for the same person already exists, a banner on the details page tells you a duplicate was found.

  1. Click Review Duplicates.
  1. On the Merge Duplicate Discoveries screen, select the duplicate you want to merge from the list. The list shows the name, insurance company, date of birth, and status.
  1. Confirm the merge.

Merging transfers all verification history from the selected discovery to the one you have open. The duplicate is then merged and no longer appears in your list. Check which discovery is open before merging, since that is the one you keep.

Statuses
  • Found: Coverage was found. Review the details and, if needed, run a VOB.
  • Not Found: No coverage was returned. See Insurance Discovery: Finding a Patient's Coverage for tips on trying again.