Note: Henry Schein One has partnered with the tuuthfairy dental insurance platform to introduce new insurance eligibility solutions in 2024. This new eligibility approach is an integrated and automated workflow that greatly simplifies the process of obtaining insurance eligibility information, delivering reliable and timely eligibility responses from top insurance payors. The Dentrix Help includes topics detailing the new eligibility solutions. For information on the new eligibility solutions, see Dentrix Eligibility Pro overview and Dentrix Eligibility Essentials overview in the Dentrix Help.
You can verify if a patient is eligible for insurance benefits from an appointment, the Appointment List, or the Family File.
The Eligibility icon indicates the patient's status.
Note: You cannot edit the text in the text field, and the text is disabled for new patients or patients who do not have a Family File record.
A green E on a white background (with a small red corner box) indicates that the patient is eligible, and new eligibility data is ready for review and approval to be saved to the coverage tables. (Once data is saved to the coverage tables, the icon changes to a white E on green background.) This icon appears for a patient whose eligibility has never been checked, or for one whose previous eligibility status has expired and the current eligibility request has returned new data.
A white E on a red background indicates that the patient is not eligible but was found successfully.
A white E on an orange background indicates that the patient was not found (hover detail recommends verifying that the patient's name is correct).
A white E on a gray background indicates that a request is in progress. The icon will turn green, red, or orange when a response is received.
Note: The eligibility statuses from payors are not standardized. A payor can use any of over 40 distinct statuses. There is an Eligible status, but all of the other statuses are the result of missing information or an input error. There is not a distinct Not Eligible status.
To check a patient's eligibility
1. In the Appointment Book, double-click an appointment for the patient whose insurance eligibility status you want to check.
The Appointment Information dialog box appears.
2. Click the Eligibility icon, and then click Submit Eligibility.
3. To get the patient's eligibility, click Submit Eligibility Request.
The Request Patient Eligibility dialog box appears.
4. Fill in the form with all the necessary information: payor name and subscriber and patient information.
5. Click Submit to get an eligibility status for the patient.