Validating subscriber IDs

To help with insurance eligibility verification, when you are adding or editing a patient's insurance plan, you can have Dentrix Ascend attempt to validate the subscriber ID and let you know if the subscriber is eligible or not eligible or if there is some kind of error that needs to be addressed. This validation process is just a quick status check to give you advanced notice of a patient's status without having to schedule an appointment.

Notes:

• This validation process is available only for primary plans.

• This validation process does not provide a breakdown of the patient's eligibility for coverage. A .pdf file with eligibility details is not saved to the patient's Document Manager, and an option to import insurance details is not available. Those eligibility details are available only for eligibility verifications that are performed for scheduled appointments (see the topics about verifying eligibility statuses and importing insurance information).

  Refer to the following table for a comparison between validating subscriber IDs and verifying eligibility statuses.

  	Validating Subscriber ID	Verifying Eligibility Status
  Purpose	Quick status check	Full eligibility verification
  Usage	Adding an insurance plan to a patient's record	Viewing a patient's scheduled appointment
  Plan Availability	Primary plan only	Primary plan only
  PDF With Breakdown	No	Yes
  Save to Document Manager	No	Yes
  Import Insurance Information	No	Yes

To validate a subscriber ID

1. Do one of the following:

   • If you are adding a patient’s primary insurance plan, specify at least the following information: Subscriber; Carrier, Payer ID, and Plan; and Subscriber ID #.

   • If you are editing a patient’s primary insurance plan, change the Subscriber ID # if necessary.

2. Click the Check Subscriber ID button  next to the Subscriber ID # box.

   

   During the check, a progress indicator appears below the Subscriber ID# box.

   

   When the check is complete, one of the following occurs:

   • If there is a problem getting a response or determining eligibility (due to a timeout issue or another error), an orange triangle icon and a message with a description of the error (such as "Subscriber/Insured Not Found") appear.

     

   • If the subscriber is not eligible, a red triangle icon and the message "Subscriber Not Eligible" appear.

     

   • If the subscriber is eligible, a green checkmark icon and the message "Subscriber Eligible" appear.

     

   • If the payer does not support electronic eligibility verification, a blue "I" icon and the message "Insurance Doesn’t Support Electronic Eligibility" appear.

     

3. Specify or change any other insurance information as needed.

4. If you are attaching insurance to the patient, or if you have changed any of the patient's insurance information, click (or tap) Save.