Nirvana Review and Next Steps

Nirvana Review and Next Steps

 

Message that will display in Appointment Notes

Practice Assistant Next Steps

NIRVANA REVIEW: PLAN INACTIVE

Call patient and obtain new insurance. Re-run eligibility in Nirvana Ops Tool in real time - if comes back inactive proceed with self-pay. If comes back unverifiable call the insurance company to verify.

NIRVANA REVIEW: MENTAL HEALTH COVERAGE INACTIVE

Call patient and obtain new insurance. Re-run eligibility in Nirvana Ops Tool in real time - if comes back inactive proceed with self pay. - If comes back unverifiable call the insurance company to verify

NIRVANA REVIEW: PLAN EXPIRES IN NEXT 7 DAYS

Call patient and obtain new insurance. Re-run eligibility in Nirvana Ops Tool in real time - if comes back inactive proceed with self pay. - If comes back unverifiable call the insurance company to verify

NIRVANA REVIEW: COULDN'T FIND PATIENT, VERIFY DEMOS AND RECHECK

Call patient, verify demographics/insurance and re-run eligibility in Nirvana Ops Tool in real time - if comes back inactive proceed with new insurance or self pay. - If comes back unverifiable call the insurance company to verify

NIRVANA REVIEW: CONNECTION FAILED, RE-VERIFY USING NIRVANA TOOL

Re-run the patient eligibility check in the Nirvana Ops tool. If comes back inactive contact patient, obtain new insurance, and re-run eligibility in real time. If comes back unverifiable call insurance company to verify.

NIRVANA REVIEW: NIRVANA DOES NOT CONNECT TO PAYER, USE PAYER PORTAL OR CALL

Verify benefits by calling payer or using payer portal. If plan is inactive please proceed with next steps listed in scenario 1.

NIRVANA REVIEW: NEW PATIENT, COPY INFO TO POLICY

Copy copay, coinsurance, remaining deductible into policy

NIRVANA REVIEW: PATIENT OOPM MET, UPDATE COPAY TO $0

Update policy copay to $0

NIRVANA REVIEW: OOPM RESET, UPDATE COPAY

Update policy copay based on Nirvana response

NIRVANA REVIEW: NIRVANA BENEFITS CURRENTLY INACCURATE, PLEASE USE PAYER PORTAL OR CALL

Call insurance or use payer portal to confirm benefits and eligibility status. Update policy with accurate information.

NIRVANA REVIEW: COULDN'T FIND PROVIDER IN PAYER DATABASE, CALL OR CHECK PAYER PORTAL FOR BENEFITS

Call insurance or use payer portal to confirm benefits and eligibility status. Update policy with accurate information.  



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