What should you do if a patient is not eligible on ECW?

If a patient is not eligible on electronic claims systems like ECW (Electronic Clinical Works), it's essential to follow the correct procedure to resolve the issue. Calling the insurance number on the back of the card is a direct approach to gather accurate and timely information regarding the patient's insurance eligibility. By communicating directly with the insurance company, you can confirm the patient's coverage, learn about any potential issues, and understand the necessary steps to rectify the situation.

This option is highly effective because it allows the provider to obtain information directly from the source and addresses any discrepancies that may exist in the system, ensuring that the patient's information is up-to-date and accurate. It also helps to clarify the coverage details that may not be apparent in automated systems.

While checking the database for errors, requesting an eligibility scan, or contacting the patient for clarification are useful actions, they may not address the issue as quickly or directly as calling the insurance company. These steps can be part of the process if further information is needed after speaking with insurance, but the most immediate and effective action is to contact the insurance directly.