How do I review and fix insurance eligibility problems before appointments?
Quick answer: Go to Insurance → Eligibility to see upcoming appointments with an eligibility problem. Each row shows the status and the payer's reason, so you can correct the insurance and have it re-checked before the patient arrives.
Who this is for: Front office staff, billers, and practice managers at organizations with Insurance Eligibility enabled.
Before you start, you'll need:
The Eligibility option under Insurance in the left navigation — contact Barti Support if you don't see it
Automatic eligibility checks configured for your organization (see the setup article below)
Steps
In the left navigation, select Insurance, then Eligibility.
Review the list. Each row is one upcoming appointment paired with one insurance record, and shows Last Checked, Patient, Upcoming Appointment, Insurance, and Status.
Narrow the list using the filters across the top:
Search Patient — find a specific patient by name
Date range — limit to a span of appointment dates
Status — filter to Not Checked, Verified, Ineligible, or Error
Insurance — filter to specific insurance networks
Location — filter to specific locations
Clear — reset all filters
Read the Status column. When a check fails, the payer's reason appears directly beneath the status — for example that the member was not found or coverage has ended.
Act on the reason:
Error — the inquiry itself had a problem. Correct the patient's insurance details (member number, name, birthdate, payer) or the missing provider information.
Ineligible — the payer says coverage is not active. Call the patient to get current insurance information.
Open the patient's profile and go to the Insurance section to make the correction. Select the pencil icon on the insurance record to edit it.
Save your change. The record returns to the nightly check queue.
What you'll see when it works
Corrected records are picked up on the next nightly run and move to Verified — a green check icon. Verified insurances drop out of your day-to-day work because Barti does not re-check a record that is already Verified or Ineligible.
Eligibility status also appears wherever you see the patient's insurance:
Home — the Insurance column on today's appointments shows the patient's primary medical and vision insurance with a status icon
Schedule — the same Insurance column on the appointments list
The patient's Insurance section — an Eligibility column on the insurance table
The insurance card — expand a card to see Eligibility Status, the reason, and Last updated
Hover any status icon to see the full status and reason.
What each status means
Status | What it means | What to do |
Not Checked | No check has been run for this insurance yet | Nothing — the nightly run will pick it up |
Verified | The payer confirmed active coverage | Nothing — proceed with the appointment |
Ineligible | The payer says coverage is not active, the member was not found, or coverage has ended | Call the patient for current insurance information |
Error | The inquiry could not be completed — a data problem, a missing provider NPI, or the payer was unavailable | Correct the insurance or provider details, or retry |
Frequently asked questions
Why is a patient still showing Not Checked?
Barti skips an insurance record when any of these is true:
The patient is marked Self-Pay
The insurance is marked Expired
The insurance has no payer ID — a network added as free text with no payer ID cannot be checked
The appointment falls outside your days-ahead window
The appointment is canceled, a no-show, or otherwise closed
Your organization has no TriZetto credentials on file
Why does a record show Error instead of a coverage answer?
Error covers everything that stopped the inquiry from producing a coverage answer — a data problem such as an invalid or missing member number, a missing or invalid provider NPI on the location, or the payer being unreachable. The reason text beneath the status tells you which. Fix the underlying data, or wait for the next nightly run if the payer was simply unavailable.
I corrected the patient's insurance. Why does the status still show the old result?
Editing insurance details does not automatically re-run the check. Click Check Eligibility on the patient's insurance to re-check it right away — this works even when the record already shows Verified or Ineligible. If nothing about the insurance changed and it was checked within the last 24 hours, Barti reuses the recent result instead of querying the payer again.
Can I check a patient's eligibility on demand, right now?
Yes. Open the patient's Insurance section and click Check Eligibility to query the payer in real time. See How do I check a patient's insurance eligibility on demand in Barti?
The button appears only for patients with active medical insurance at organizations with eligibility enabled.
Where do copay and deductible amounts show?
When automatic checking is on for your organization, expand the patient's insurance card or open the insurance record to see Eligibility & Coverage — Plan Name, Coverage Start Date, Coverage End Date, Office Copay, Specialist Copay, Coinsurance %, Individual Deductible, Family Deductible, Deductible Renewal Date, Individual Max OOP, and Family Max OOP. These come from the payer's response and are read-only. Authorization #, Authorization Date, and Authorization Expiration Date are entered by your staff — payers do not return them with an eligibility response. Fields the payer did not report show a dash.
Can I set the eligibility status myself?
Only if your organization does not have automatic checking turned on. In that case, the insurance record has an Eligibility Status dropdown so you can record what you confirmed on the payer portal, along with a stamp showing who last updated it and when. Once automatic checking is on, the status and coverage amounts come from the payer and can't be hand-edited.
Does this work for vision insurance?
Automatic checking applies to medical insurance. Vision insurance records show an eligibility status, but Barti does not send automated eligibility inquiries to vision payers — verify vision benefits with the vision payer directly.
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