Coverage Coordination Through Availity

Q. If a patient has primary, secondary, and perhaps even tertiary insurance, will the electronic data exchange clearinghouse Availity clarify which is primary, secondary, and tertiary when verifying the patient's eligibility and benefits through the Availity portal?

A. The primary and secondary insurers should show which health plan is primary and which is secondary in the Eligibility and Benefits (E&B) result. It is in the Supplemental Benefit Description section. (Of course, the health plan has to have the information on file for Availity to be able to display it.)

The user would have to run an E&B for both health plans to view the coverage information.


TMA Practice e-tips main page

Last Updated On

May 31, 2016