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Batch Request File Format

In order to send a Batch of Eligibility requests, please create a CSV file and upload it to the website. 

Instructions

1. Download and save this sample batch eligibility file: SampleBatchFile.csv
2. Open the sample batch eligibility file using Microsoft Excel or any other spreadsheet utility.
3. Replace the sample data with your patient's information starting on Line 2 (Keep the column headings as they are). You may add as many patients as you'd like to the batch.
4. Click on File, Save As... and choose the CSV (Comma Delimited) option and save the file to your desktop (or any other location on your hard drive).
5. Log in to www.MedicareEligibility.com and click on Eligibility, Batch Eligibilty, Upload Request File.
6. Click on Browse... and select the file you saved in step 4.
7. Click on Upload.

If there were any errors or problems with the batch file, you'll be able to find those in the Confirmation Report that is generated immediately.  Please make the corrections to the errored patients, and upload another batch file with the errored patients only.

As soon as your response file is ready to download, you'll find it in the Eligibility, Download Response File section.  This may take up to 24 hours to generate the response file, but will generally be available sooner.

Variables

These are all the possible variables you can send on the eligibility batch request.  Some of them require others to be sent.  All the restrictions are listed next to the fields in the parentheses.  All dates must be sent in the format mm/dd/yyyy (ie 07/29/1955).

"LName" = Patient Last Name (35 letters max)
"FName" = Patient First Name (25 letters max)
"MI" = Patient Middle Initial (1 letter max)
"Suffix" = Patient name suffix (ie. "Jr") (10 letters max)
"BDate" = Patient Birth Date (must be in the past)
"PatID" = Patient Insured ID/Policy # (between 2 and 80 characters)
"ServTypeCode" = Service Type Codes
"NPI" = Provider's NPI Number (must be valid npi number)
"FromDate" = Service Date (required if there is a "ToDate") (Must be no more than 1 year in the past, and up to 4 months in the future)
"ToDate" = Service Date To (spanned dates) (Must be no more than 1 year in the past, and up to 4 months in the future)
"PayerID" = The Payer ID of the Insurance Company you're checking (only used for non-Medicare)
"SSN" = Patient's Social Security Number (only used for non-Medicare)

Minimum Requirements for Medicare Batch Eligibility
  • PatID
  • LName
  • Either FName or BDate
  • Service Type Code
  • NPI - If left blank, NPI from "My Account" will be used
  • FromDate - If left blank, today's date will be used

Requirements for Medicaid, BCBS, and Commercial Batch Eligibility
  • One or more of the following items may be required:
    • LName
    • FName
    • BDate
    • PatID
    • SSN
  • PayerID
  • Service Type Code
  • NPI - If left blank, NPI from "My Account" will be used
  • FromDate - If left blank, today's date will be used

 

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