> ## Documentation Index
> Fetch the complete documentation index at: https://help.elationhealth.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Running Eligibility

> Learn how to run real-time eligibility checks in Elation Billing and EHR

This article provides step-by-step instructions on how to run real-time eligibility (RTE) checks in both Elation Billing and Elation EHR.

<iframe src="https://player.vimeo.com/video/1127868578" frameBorder="0" allowFullScreen />

## Overview

### What is Running Eligibility?

Running eligibility (also called Real-Time Eligibility or RTE) is the process of verifying a patient's insurance coverage status electronically. This checks whether the patient's policy is active and may provide additional coverage details.

### Why is Running Eligibility important?

Verifying eligibility before providing services helps prevent claim denials due to inactive coverage, identifies patient responsibility amounts, and ensures claims are submitted to the correct payer.

## Workflow Instructions

### Prerequisites

Before running eligibility, you must first [enroll for a Payer's Eligibility](/articles/enrolling-for-claims-submission-era-and-real-time-eligibility-edi).

### Running RTE in Elation Billing

You can run RTE from any Patient or Superbill Page.

1. **Check the Policy** - Locate the patient's insurance policy and click the **Check** button.

   <img src="https://mintcdn.com/elationhealth/_WF8YQMpuRByusIR/images/intercom/f8ff1cdf9cae_RTE_1.png?fit=max&auto=format&n=_WF8YQMpuRByusIR&q=85&s=d2156a04024f931715de6d3ada08a69c" alt="An image of Samwise Gamgee's Patient Page. In the center, within his ME Medicaid policy, a coral arrow points at the blue button that says Check." width="2394" height="1268" data-path="images/intercom/f8ff1cdf9cae_RTE_1.png" />

2. **Select Check Type** - Choose one of the following options:

   * **E-Check Eligibility** - Run an electronic eligibility check with the payer

   <img src="https://mintcdn.com/elationhealth/b_VQbpfEoUHjBEuz/images/intercom/82580789a5fe_RTE_2.png?fit=max&auto=format&n=b_VQbpfEoUHjBEuz&q=85&s=7daadd77991ca314b2e72302f297e7e5" alt="Image" width="1246" height="1030" data-path="images/intercom/82580789a5fe_RTE_2.png" />

   * **Manual Check** - Manually mark a policy as active or inactive when electronic check is not available

   <img src="https://mintcdn.com/elationhealth/b_VQbpfEoUHjBEuz/images/intercom/c1963733161f_RTE_2.png?fit=max&auto=format&n=b_VQbpfEoUHjBEuz&q=85&s=08430b00a6ba0241ae37f7b7c114b93d" alt="Image" width="1246" height="1030" data-path="images/intercom/c1963733161f_RTE_2.png" />

3. **Run the Check** - Confirm and run the eligibility check.

   <img src="https://mintcdn.com/elationhealth/axN6V524bgYhtISH/images/intercom/261266a4f676_RTE_3.png?fit=max&auto=format&n=axN6V524bgYhtISH&q=85&s=c0ffe5f19c11c66264f548f702bec68e" alt="Image" width="1244" height="1504" data-path="images/intercom/261266a4f676_RTE_3.png" />

4. **View the Report (Optional)** - You can view reports for both Active and Inactive policies to receive more information.

   Click the Report summary to view more information. The info available is determined on a payer-by-payer basis, dependent on what the payer provides.

   <img src="https://mintcdn.com/elationhealth/CWM1OVXHaDp9DnEy/images/intercom/76b4ac1a6e6e_RTE_4.png?fit=max&auto=format&n=CWM1OVXHaDp9DnEy&q=85&s=487428cbb3f16f7102f5b250cc01294d" alt="Image" width="1166" height="311" data-path="images/intercom/76b4ac1a6e6e_RTE_4.png" />

***

### Running Eligibility in Elation EHR

For **Elation EHR + Billing** users, RTE can also be run in the EHR. Running RTE in the EHR will update the Eligibility in Elation Billing, and vice versa.

1. **Open Patient Demographics** - Open the patient's demographics page.

2. **Navigate to Insurance** - In the sidebar of the pop-up window, select **Insurance, Payment, & Membership**.

   <img src="https://mintcdn.com/elationhealth/_WF8YQMpuRByusIR/images/intercom/eeb0af9264e9_EHR_RTE_2.png?fit=max&auto=format&n=_WF8YQMpuRByusIR&q=85&s=af2ab37f1a039c9ddce78dc1efe8e11e" alt="In the sidebar of the pop-up window, select Insurance, Payment, & Membership" width="716" height="1110" data-path="images/intercom/eeb0af9264e9_EHR_RTE_2.png" />

3. **Check Eligibility** - Click the eligibility check button.

   <img src="https://mintcdn.com/elationhealth/axN6V524bgYhtISH/images/intercom/034b8eb47a2c_Screenshot_2023-09-07_at_3.56.20_PM.png?fit=max&auto=format&n=axN6V524bgYhtISH&q=85&s=938d748e4395d441a6d733ad96a16ff4" alt="Image" width="1904" height="964" data-path="images/intercom/034b8eb47a2c_Screenshot_2023-09-07_at_3.56.20_PM.png" />

4. **View the Report (Optional)** - Review the eligibility report for coverage details.

   <img src="https://mintcdn.com/elationhealth/axN6V524bgYhtISH/images/intercom/1da97cc75e8f_Screenshot_2023-09-07_at_3.56.20_PM.png?fit=max&auto=format&n=axN6V524bgYhtISH&q=85&s=8e2eecf8a67760de20956e324adffdef" alt="Image" width="1904" height="964" data-path="images/intercom/1da97cc75e8f_Screenshot_2023-09-07_at_3.56.20_PM.png" />

***

### In-Network and Out-of-Network Information

Each Eligibility report is provided directly by the payers and their own clearinghouses, and each payer offers different levels of information.

<Note>
  While some payers may provide information about both In- and Out-of-Network coverage, the report will not indicate NPI-specific information. For this information, please contact the payer directly.
</Note>

## Related Articles

* [Enrolling for Claims Submission, ERA, and Real-Time Eligibility](/articles/enrolling-for-claims-submission-era-and-real-time-eligibility-edi)
* [Troubleshoot Eligibility](/articles/troubleshoot-eligibility)
* [Add or Edit Patient Insurance](/articles/add-or-edit-patient-insurance)
