Submit a patient for an eligibility check on the portal

Practices can submit patients on the portal to have health plan eligibility and benefits reviewed to ensure coverage. 

Step 1: Submit a patient

1. Login to the portal. Navigate to "Eligibility" 

2. On the top right, press Submit a new patient.

3. Add the patient’s first name, last name, date of birth, insurance, and member ID. Please ensure the information provided matches the patient’s insurance card.

4. Once you press Submit, the patient will appear under the Pending tab.

Step 2: View eligibility check results

Once Zaya has reviewed the information provided, the results will be moved to one of the following categories:

1. Zaya billable: This indicates that the patient is covered, has an active plan, the rendering provider is in-network with Zaya’s insurance, and Zaya is contracted with the subplan. Claims for these patients can be submitted through Zaya, and they will also appear on the Claims page.

2. Self bill: This indicates that the patient is not covered, does not have an active plan, the rendering provider is not in-network with Zaya’s insurance, and/or Zaya is not contracted with the subplan. These patients will not appear on the Claims page.

3. Invalid: This indicates that the information provided for the patient was invalid, and Zaya was unable to locate the patient's insurance information with the health plan. 

• If you receive updated information on the patient or their health plan, press "Update information" to review and resubmit the patient for an eligibility check
• If the information submitted through the portal is correct, please message into support@zayacare.com and we will investigate