During the installation of Dentrix Enterprise, you can choose to install a service for handling automated insurance eligibility verifications for patients' upcoming appointments. Additionally, the service requires eTrans (eClaims) or Data Services accounts to be set up in Dentrix enterprise. You can also configure settings to control the service.
Notes:
Contact your Strategic Account Executive for pricing to use this service, to sign up for eTrans or Data Services accounts, and to enroll in eligibility verification.
Accessing the Data Services settings requires the "Integration Settings, Data Services" security right.
To set up automated insurance eligibility verification
While logged in to the Central clinic, in Office Manager, expand the Maintenance menu, point to Practice Setup, and then click Integration Settings.
Note: You can edit Data Services settings only if you are logged in to the Central clinic; otherwise, you can only view them.
The Integration Settings dialog box appears.
Select the Data Services tab.
If applicable, do one of the following:
If the Password - Integration Settings, Data Services dialog box appears, user verification has been assigned to the "Integration Settings, Data Services" task. Do one of the following:
If your user account has been granted the "Integration Settings, Data Services" security right, enter your credentials in the User ID and Password boxes, and then click OK.
If your user account has not been granted the "Integration Settings, Data Services" security right, have a user with permission temporarily override this restriction so you can access the Data Services settings this one time. The overriding user enters his or her credentials in the User ID and Password boxes and then clicks OK.
If a message appears, informing you that you do not have rights to this operation, your user account has not been granted the "Integration Settings, Data Services" security right. To have a user with permission temporarily override this restriction so you can access the Data Services settings this one time, do the following:
On the message, click Yes.
In the Password - Integration Settings, Data Services dialog box, the overriding user enters his or her credentials in the User ID and Password boxes and then clicks OK.
The Data Services settings appear on the right. The General tab is selected by default.
The eligibility service requires eTrans (eClaims) or Data Services accounts. Make sure the needed accounts are set up and the correct clinics are assigned to each account. For information about adding, edting, and deleting accounts in Dentrix Enterprise, see the topic about managing Data Services accounts.
To set up the options for checking eligibilities, select the Eligibilities tab.
Note: The service checks eligibilities every 60 minutes. You cannot change this.
Under Eligibility Options, do the following:
In the Send [X] days of appointment information (including today's date) box, enter a number between 1 and 99 to specify how many business days worth of future appointments, starting from today's date, that you want the service to check eligibilities for.
Select the checkboxes that correspond to the types of coverage that you want the service to verify eligibilities for: Primary Dental, Secondary Dental, Tertiary Dental, and/or Quaternary Dental. At least one checkbox must be selected.
Click OK.
Notes:
The practice default setting Eligibility Check Date valid for indicates how long a verification of insurance eligibility is valid. In that box, enter how long an eligibility check should be valid for. The eligibility service will not re-check a patient's eligibility for any appointments before the specified time has elapsed.
You can still manually specify a patient's eligibility by editing his or her insurance information in Family File. However, with the automated insurance eligibility verification feature, a patient's eligibility information is updated automatically.