Front Desk, Scheduling, Registration staff: Current coverage must be terminated if RTE returns 'Plan Mismatch' status

Beginning Tuesday, July 12, if Real Time Eligibility (RTE) returns a status of Plan Mismatch on an existing coverage record on the patient's registration, the current coverage must be terminated. Moving forward, an RTE status of Plan Mismatch on existing coverage will not allow the patient to be checked-in; a corrected coverage must first be entered and verified.

All front desk, scheduling and registration users must follow the steps listed in the “RTE – Plan Mismatch” Tip Sheet to ensure accounts are billed out timely and appropriately.

Any questions or concerns with this change should be directed to Joe Palumbo, Regional Director of Pre-Arrival.

Background on this Change

Currently we have a high volume of accounts where “Plan Mismatch” is returned from Real Time Eligibility (RTE) and users are selecting “file response” in the bottom of the response history screen without correcting the coverage. Understandably, users see the coverage as “eligible” in the “Plan Mismatch” message and this causes confusion. 

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