Eligibility Module

CopilotPro21's Eligibility Module streamlines the Medicaid eligibility verification process at the provider level. The application programmatically checks all of your consumers daily. It notifies you the instant a consumer is no longer eligible and enrolled within their respective program, which ultimately helps reduce delivering services to ineligible consumers.

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*Data on this page is fictitious and does not include any real PHI

Key Features

Email Notifications

Email notifications provide automated, real-time updates on eligibility status. These alerts keep users informed, reduce manual follow-ups, and support a more efficient workflow.

Future Checks

Future checks allow users to view whether a consumer’s eligibility is set to terminate at a later date. This visibility helps teams plan ahead with confidence and avoid rendering service to ineligible consumers.

Monitor MCO Switches

MCO switch monitoring enables users to identify when a consumer changes managed care organizations. This helps keep records accurate and ensures providers bill the appropriate payer.

Alert Dashboard

The alerts dashboard provides a centralized view of key eligibility activity, including MCO changes, eligibility alerts, and status updates. This consolidated visibility helps users quickly monitor the results and stay informed without navigating multiple areas of the system.