Sammy Eligibility New and Improved

July 16th, 2020

Check a patient's eligibility status with the click of a button!  There are now over 600 commercial, BCBS and even State Medicaid plans that have been added to the list of insurances that can be checked directly from the patient’s chart!  

Click here to search for a specific plans to see if they are available. 

What's New?

Until now eligibility directly from Sammy was only available with an annual subscription fee.  You can now sign up and pay per transaction. 

Subscription (annual fee)

  • Unlimited transactions for all participating insurance plans. Non-Participating insurance transactions for just 25 cents per check.
  • Medicare Batch Eligibility - check patients with upcoming appointments and holds claims for patients that have not yet met their deductible as part of the morning index.
  • Commercial Carriers - available for most BCBS plans and Commercial plans
  • State Medicaid Plans and other Non-Par plans may also be checked for an additional fee per check. Click here for a list of payers that will require a transaction fee.

Non-Subscription (per transaction fee)

This can save you time and money.  Here's how:

Commercial Carriers 

  • Verify patient information and eligibility right from their chart (no need to have access or log in to carrier websites).
  • Receive deductible, copay and eligibility status amount remaining for the year.
  • Only 25 cents per check.
  • Save the results in your patient file cabinet for future reference.
  • No minimum monthly fee and transactions never expire. 

Medicare 

  • Verify patient information and eligibility right from the chart
  • Receive deductible amount remaining for the year or if the patient is a Qualified Medicare Beneficiary (QMB)  (appears on the patient chart)

  • Receive primary insurance information if Medicare is the secondary payer
  • Receive  Managed Care Organization (MCO) so you can bill the correct insurance.
  • Save Results in your patient filing cabinet.
  • Only 25 cents per check.
  • No minimum monthly fee and transactions never expire. 

How do I sign up? 

If you do not currently have a subscription, click on the eligibility button from a patient's chart.  

Click the Yes, Sign me up!  This will submit your enrollment request to us.  If any activation or setup is required, our staff will process the request and contact your office when it has been completed.

If you do not want to sign up at this time you may decide at a later date and time to sign up.  Just come back to the eligibility button at any time to submit your request.

Is there an Enrollment process for specific payers?

Yes, some carriers will require a setup. These payers will indicate if enrollment is necessary. If you want to be enrolled, you can submit your request by clicking on the 

Enrollment Required:  Click here to enroll. 

This will notify our paperwork department with your request.  Your office will be contact when the enrollment has been completed. 

 

Purchasing Transactions

You can purchase transactions at any time.  Click the Purchase Transactions, and answer Yes. 

A credit card is required to purchase transactions.  The office address is pre-populated but can be changed if necessary.  

**Credit Card information is NOT stored and will need to be entered each time transactions are purchased.  

Transactions may be purchased in the following increments: (Transactions never Expire)

100 transactions ($25.00)
200 transactions ($50.00)
400 transactions ($100.00)
800 transactions ($200.00)
2000 transactions ($500.00)
3000 transactions ($750.00)
4
000 transactions ($1000.00)
6000 transactions ($1500.00)

Once I sign up when will I be able to start checking eligibility?  

Almost immediately, you will need to purchase transactions first!  Medicare does require a setup process that may take up to 3-5 business days to complete from the time you request a provider to be enrolled.

Click here for a list of insurances that require an enrollment process.  

How will I know if eligibility is available for an insurance plan? 

That's simple, if the Eligibility/Referral button on the patient's chart is green, then one or more of the insurances on the chart are available to be checked for eligibility.   If the button is blue, then nothing may be checked.

What do I do if a find an insurance that is on the available list but the button is blue? 

To check eligibility, the insurance must be enabled in Sammy for electronic claims submissions. If your insurance entry is not set-up for electronic claim submissions the eligibility button will not be green. 

Can I automatically save my eligibility results in the patient's filing cabinet?  

Yes!  For commercial carriers you will need to set Feature Flag # 234 "Auto Save Commercial Eligibility.  If this flag is checked, you will still have the option to print your results but they will be automatically saved. To set this go to Utilities, Feature Flag Settings.  Click on the tab Flags 209-248. Click the check box to set it.

 For Medicare, you will need to update Medicare Eligibility preferences and check the option  "Automatically Save Results In the Filing Cabinet".  Go to Utilities, System Setup.  Click on Enter Setup Area and MCR Elig Preferences. 

**Please note that if your office is does not have a Medicare Annual Subscription,  not all of the options here are applicable.  If you would like to learn more about our Medicare Batch Eligibility feature click here or send an email  to finance@icssoftware.net  for pricing and/or to schedule a demo.

Can I change my subscription? 

Yes! you can update to an annual subscription at any time!  Just send an email to finance@icssoftware.net with your request.