Anagram’s app robustly handles all aspects of the eligibility and claim submission flow. In some instances, you may desire to use elements of the Anagram App while leveraging the API to minimize double data entry. Anagram’s app has user interfaces for the full cycle of vision plan billing:

  1. Eligibility via direct or universal search
  2. Displaying all eligibility results and details
  3. Flows to match results with the initial eligibility search
  4. Benefit interpretation
    1. Out-of-network benefit calculator
    2. In-network benefit details in PDF format
  5. Out-of-network claim submission
  6. View past eligibility checks and claim details

Pushing Patients to Anagram APP via API

1

Create Patient

You must do this for the patient record to appear in the Anagram App. Initiating an eligibility request by itself does not. Creating a Patient returns a unique code. Save this code to use in the next step. Create Patient resources here.

If you have multiple locations, you’ll want to specify the location code when creating the patient. This code will identify the location that the patient will be linked to. To pull a list of your location codes, see the List Locations endpoint.

2

Initiate Eligibility Request and link it with the patient

Use the code from the previous request to link arbitrary eligibility request using the Patient Eligibility Link endpoint. Eligibility check will appear on the patient’s profile in the Anagram web app.

3

Redirect your user

The linking endpoint will provide a URL to the patient’s profile in Anagram’s app.

Continue in the Anagram App

1

View Patients and Eligibiltiy Results

Staff can log in to the Anagram App and view all patients and corresponding eligibility results sent via the API.

2

Matching Eligibility Results

All eligibility results will be returned for each patient. If more than one result is returned, staff should interpret it and identify the correct patient.

3

Benefit Interpretation and Claim Submission

Staff can view and interpret the plan benefits and initiate out-of-network vision claims in a few easy steps.