Dentrix Enterprise
Help

Entering insurance eligibility for patients

You can enter a patient's eligibility for insurance benefits under any of his or her dental and medical insurance plans.

Note: For dental plans, you can manually specify a patient's eligibility by editing his or her insurance information; however, if your practice uses the automated insurance eligibility verification feature, a patient's eligibility information is updated automatically.

To enter a patient's insurance eligibility

1.   With a patient selected in the Family File, double-click the Insurance Information block.

The Insurance Information dialog box appears.

2.   On the Dental Insurance tab or the Medical Insurance tab, in the Coverage Order list, select the insurance plan that you want to enter eligibility for.

3.   Under Plan Information, in the Last Plan Eligibility Check field, type today's date or a different date as the date that you verified the plan's effective and expiration dates. If known, type the Plan Effective date and Plan Expiration date.

4.   Under Patient Information, do one of the following:

·        If the patient is not eligible for benefits under this plan, select the Not Eligible check box.

·        Type the date that eligibility started in the Eligibility Start field and, if known, the date that eligibility will end in the Eligibility End field.

Note: If you have entered a Last Eligibility Check date, and if the Not Eligible check box is clear, you must enter an Eligibility Start date in order to save the insurance information. The Eligibility End date is not required.

·        In the Last Eligibility Check field, type today's date or a different date as the date that you verified the patient's insurance eligibility. If the patient is not eligible for benefits under this plan, select the Not Eligible check box; otherwise, type the date that eligibility started in the Eligibility Start field and, if known, the date that eligibility will end in the Eligibility End field.

Notes:

·        If you have entered a Last Eligibility Check date, and if the Not Eligible check box is clear, you must enter an Eligibility Start date in order to save the insurance information. The Eligibility End date is not required.

·        The color of the eligibility icon (which will also appear on the patient's appointments) varies according to the eligibility status of the patient's primary dental insurance; no other dental or medical plan affects the color. The meaning of the colors are as follows:

Yellow is "Not Checked" or "Reverify."

Green is "Eligible."

Red is "Not eligible."

5.   Repeat steps 2 - 4 as needed to enter eligibility information for other insurance plans.

6.   Click OK.

Tip: You can check the status of the patient's insurance eligibility for his or her upcoming appointment from the Appointment Book.