Insurance verification and eligibility checks

Step-by-Step Breakdown

Detailed explanation of each automated stage in the workflow.

1. 1

   Trigger

   Appointment scheduled or modified

   New patient appointment is created or existing appointment is updated in the practice management system. System captures patient ID, insurance details, and scheduled treatment codes.

   DentrixEaglesoft
2. 2

   Action

   Extract patient insurance information

   Retrieves patient's current insurance carrier, policy number, group number, and subscriber details from patient record. Validates that all required fields are present for verification.

   DentrixOpen Dental
3. 3

   Action

   Submit eligibility verification request

   Sends automated eligibility inquiry to insurance carrier using patient's policy information and planned treatment codes. Queries real-time benefits, deductibles, and coverage percentages.

   RevenueWellCurve Dental
4. 4

   Decision

   Check verification response status

   Evaluates insurance carrier response to determine if eligibility was successfully verified or if additional information is needed. Routes workflow based on verification success or failure.

   RevenueWell
5. 5

   Action

   Update patient record with benefits

   Automatically populates verified insurance benefits, co-pays, deductibles, and coverage limits into patient's treatment plan and financial record. Calculates estimated patient responsibility.

   DentrixEaglesoft
6. 6

   Action

   Notify front desk team

   Sends automated alert to front desk staff with verification results and any required patient communications. Flags accounts needing manual follow-up for failed verifications.

   WeaveRevenueWell
7. 7

   Output

   Generate verification summary report

   Creates comprehensive insurance verification report showing patient benefits, coverage details, and estimated treatment costs. Report is accessible to clinical and administrative staff.

   DentrixOpen Dental

Related Dental Practices Articles