Taking Action on Insurance Certificates with Auto-Review Results
- Anastasia Medovkina (Deactivated)
Manually checking if the provider complies with the insurance requirements may be daunting. The Auto-Review Results make checking insurance information and acting on insurance documents faster.
While ServiceChannel strives for accuracy, we recommend reviewing the information entered before approval. ServiceChannel cannot be held responsible for any inaccuracies.
With the Auto-Review Results, the insurance management for you and your providers includes 7 steps.
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- Your provider uploads an insurance certificate.
The Optical Character Recognition technology detects it and fills out the information in the right fields.
If the insurance document is not the Acord 25 form, your provider will enter the information manually.
- The Auto-Review Results show if the information entered meets your requirements.
- The provider checks the entered information.
- The provider submits the document(s) to you.
- The Auto-Review Results show if your requirements are met.
- You make a decision on insurance approval on one page.
While ServiceChannel strives for accuracy, we recommend reviewing the information entered before approval. ServiceChannel cannot be held responsible for any inaccuracies.
About Insurance Auto-Review Results
Once a provider has submitted insurance documents, you may see four states of validation results in the Review status in the Compliance Table:
- Green state. It indicates that the Auto-Review Results detected 100% of the requirements are met.
- Yellow state. The Auto-Review Results detected that more than 30% but less than 100% of the requirements are met.
- Red state. It shows that the Auto-Review Results detected 30% or less of the requirements are met.
- Grey state. It indicates the insurance uploaded cannot be detected by OCR and was submitted before you turn on the Auto-Review Results.
To learn more about other statuses of insurance documents, such as approved, rejected, etc., read Managing the Compliance Table.
- Click Review to view insurance documents for a provider.
The Review Insurance Documents page appears.
About the Review Insurance Documents Page
In the Review Insurance Document window, you can:
- View the information about the selected insurance certificate.
- Switch between insurance certificates.
- Select insurance documents one by one or select all to take action.
- Switch between providers and the documents they uploaded.
- Take action on selected insurance documents.
- Review the insurance certificate.
Taking Action on Insurance Certificates with Auto-Review Results
To approve or reject insurance certificate(s), you need to open them in Review Insurance Document window.
In the Compliance Table, click Review for the needed insurance type from a provider.
Note that if the uploaded document has not been detected by the OCR, the icon above the Review status on the Compliance table will be grey. Insurance certificates uploaded before you requested the Auto-Review Results function will have the grey icon till your provider makes updates and submits them for your approval.
- On the left, switch between the insurance types to view if any requirements are not met.
Check the correctness of the information.
While ServiceChannel strives for accuracy, we recommend reviewing the information entered before taking action. ServiceChannel cannot be held responsible for any inaccuracies.
- Select the checkboxes next to the certificates on which you want to take action.
(Optional) Click Approve to accept the insurance certificate(s) uploaded by a provider.
If some of the requirements are not met, and you approve the document, you will be prompted to enter the reason for this decision (optional). In this case, the insurance certificate will get the Approved with Exception status.
If the certificate has the future effective date, it will have the Approved (Future Effective Date) status.
(Optional) Click Reject to decline the provided document(s) and notify the provider about the requirements that have not been met.
The provider will see what to correct in the rejected insurance or will upload a new document for review.Do not take any action on the certificate if you are unsure of the decision. The certificate will stay in the Review status.
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