View and Update Discrepancies

In the Common Financial Clearance interface, if differences exist between the information submitted in the request and what the payer has on file, an alert is displayed. Information contained in the application is displayed in the Current row, while the response from the payer is displayed in the Response row.

1. To update Oracle Health Patient Administration with the data received from the payer, select Accept.
2. To reject the discrepancy, select Reject and the information is not updated in Oracle Health Patient Administration.
3. To change the previous action of Accept or Reject, select Editand select Reset to override the previous selection.
4. Open the Eligibility Details dialog box. The number of discrepancies is displayed.
5. View Discrepancies and determine if one or more of the following discrepancies exist:
   1. Health Plan
   2. Patient Name
   3. Birth Date
   4. Gender
   5. Member ID
   6. Group Number
   7. Group Name
6. If a discrepancy exists, review the information and select Accept or Reject. When all discrepancies are resolved, the following message is displayed: All discrepancies resolved.
   1. If you select Accept, the information is displayed in the health plan information in Oracle Health Patient Administration.

      Note:

      These values can be located when managing financial responsibility and selecting the edit icon next to the patient's insurance. Oracle Health recommends that you allow these fields to be updated by the system when accepting a discrepancy in the eligibility response, and not to update these fields manually.
   2. If you select Reject, the information from the payer is not displayed in Oracle Health Patient Administration, but is still displayed on the eligibility response.