Patient Selection Logic
SpexFetch pulls patients based on your selected filters and automatically attempts to verify their vision benefits.
Batch Processing Behavior
- Patients with active benefits are moved to
Valid
- Previously verified patients will not reappear on repeat runs
- Only new or
Not Verifiedpatients are processed always
Understanding Verification Results
✅ Valid
Patient has active vision benefits and is eligible for a routine eye exam.
🚫 Not Verified
SpexFetch skipped the patient. Common reasons include:
- Insurance Plan Mapping: Only configured plans are processed. Unmapped plans are ignored.
- Self-Pay: No verification is needed or performed.
❌ Invalid
Verification was attempted but failed. Common reasons:
- Incorrect Member ID
- No Match Found after checking variations of name, ID, and SSN
- Out of Network
NEXT STEP: Manual review required when a patient is marked
InvalidPerform these crosschecks
- Check for typos in the Member ID
- Confirm patient's legal name and DOB matches insurance records and/or insurance card.
- Verify that the insurance is still active with patient by calling or texting them.
