Eligibility
6 min
Your central resource for accessing real-time patient eligibility and coverage information through the Surescripts network.
Eligibility services provide:
- Coverage verification
- Patient eligibility details
- Payer and plan information
- Data to support care and treatment decisions
Documentation
Verify patient coverage and eligibility information
Verify eligibility for multiple patients at once
How It Works (High-Level)
- Enable transmission of patient and coverage information
- Use coverage information to support benefit verification workflows
Key Resources
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💬 Support
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Standards Information
Eligibility transactions are based on the ASC X12N 270 Health Care Eligibility Benefit Inquiry and 271 Health Care Eligibility Benefit Response standards, which support real-time exchanges of patient eligibility and benefit information.
- Use official X12 implementation guides for complete transaction requirements and technical specifications.
- Surescripts documentation highlights how the X12 standards are implemented within the Surescripts network.
- Official standards documentation and licensing information are available at https://x12.org/