Check Insurance Eligibility

Verify Insurance Eligibility from the patient account without exiting SOAPware. The sftp password assigned during Trizetto/Gateway EDI enrollment must be added to Clearinghouse Options (Steps 6 and 7) before this feature is automated

Check Insurance Eligibility


1. Open Patient Account and click on Insurance tab.

2. Click Check Eligibility Button to download patient insurance eligibility. Download will begin automatically.

Eligibility Warnings

Note: Medicare requires the Eligibility enrollment be renewed once a year.  If your renewal is due, you will receive a message when checking eligibility, and will not receive the eligibility results until the enrollment renewal is performed. This can be updated on the TriZetto website. Contact TriZetto Customer service for details.

Some payers require a legacy ID or Tax ID for checking eligibility. If this message pops up when checking eligibility, please refer to step 13 in the Insurance Company Setup. Setup Insurance Company