Insurance eligibility is a simple way to view the status of your patient’s insurance. On your appointment card, in your Zocdoc Inbox tab, you can view the insurance eligibility status for your bookings. This saves you time by identifying any appointments that have an ‘inactive’ insurance and may require patient outreach.

Please note that the insurance eligibility status has no bearing on whether the practice will be charged a booking fee.
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Insurance eligibility automatically verifies the patient’s insurance carrier and plan status at the time of booking. We’ve partnered with Availity, the nation’s largest real-time health information network, to automate the insurance eligibility look-up process so you can tell, at a glance, on your appointment card whether the insurance plan coverage is active or inactive.

Currently, we support most top insurance carriers, including Aetna, Cigna, United Healthcare, and BlueCross BlueShield. We’re working on supporting additional carriers.

Log into Zocdoc, go to your Inbox, and select a booking. The appointment card will show on the right-hand side. The Eligibility section will appear only for supported insurances.

Select View report to see more insurance information, including the group number, eligibility start and end date, and carrier phone number. You have the option to re-verify eligibility which will run the check again, or export the report.

Insurance information that is “Active” means that Availity has verified insurance coverage is active at the time of the eligibility inquiry, while “Inactive” means Availity has determined coverage has lapsed (or is not active). Note: These results do not consider whether a provider is in-network with the insurance plan.
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We may not be able to show an automated eligibility response if any of the following fields are missing or do not match the insurers’ information: first name, last name, date of birth, insurance carrier, insurance plan, or Member ID.

However, if a patient’s insurance is one of the supported carriers, you will have the option to request an eligibility inquiry by selecting Request eligibility and updating the patient’s information manually to run an eligibility check.

For example, if a patient with Aetna insurance used a nickname instead of their legal first name to book their appointment, you will see the option to Request eligibility. Selecting this option would open a new tab allowing you to manually change the patient’s name to the legal name printed on their insurance card and resubmit the eligibility request.
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The appointment card displays a patient's insurance information at the time of booking. If a patient makes changes to this information after the booking, these updates will not be reflected in the appointment card. However, if a patient notifies your practice of a change in insurance, you can still verify this info is active by selecting Update and filling in the required patient information fields or through your existing eligibility process.
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We do not support eligibility checks for past appointments. If you need to reference eligibility information after an appointment, we recommend you export the eligibility report ahead of the appointment.