For use with NexHealth Verification and Forms
Overview
Set up Verification information and settings
Before you run verification checks, you’ll need to set up a few settings to get started.
1. Set up your NPIs and Tax IDs.
For customers with fully-synced systems (available for Dentrix, Eaglesoft, and Open Dental), enter your NPI/Tax ID information into your health record system.
In Settings → NPI and Tax ID, enter a fallback NPI or a global NPI.
2. Set the destination folder for your Eligibility PDF sync.
Eligibility Summary PDF sync is only available for sync customers.
3. Adjust the verification window if desired.
The default is verification window is 7 days before appointments. Verification begins automatically when an appointment enters the verification window, and you can adjust the verification window.
4. Adjust your verification limit in Settings.
Your NexHealth subscription includes 800 verifications per month. After 800, each additional verification is $.20. You can allow overages by navigating to Settings --> Usage management and toggling ON the Allow overages toggle.
Run insurance Verification checks and update records
Verification will happen automatically based on information from the most recent source of information, whether that is the Dental Insurance verification form, info from EHR or from manual verification. Automated verification will run…
…when the appointment enters the verification window, or…
…immediately upon receipt of information (if the appointment is already in the verification window).
1. Collect and record patient insurance information.
You can either enter insurance information through manually verifying eligibility checks on demand or collect it through the Dental Insurance verification form.
Syncing insurance information from your health record system is only available for customers syncing with Open Dental, Dentrix, or Eaglesoft.
2. Verify eligibility on demand, or allow NexHealth to run automated verifications.
You can manually Verify eligibility on demand, but NexHealth will automatically run verifications on any insurance for appointments which are within the verification window.
Automatic verifications are only available for customers with sync.
3. Download the Eligibility Summary PDF and upload it to your health record system.
Download the Eligibility Summary PDF from Verifications, and then upload it to your health record system.
Syncing users of Dentrix, Open Dental, and Eaglesoft can set up the Eligibility Summary PDFs to sync back automatically to their health record system, but will still need to transcribe the details from the summary to your record system’s fields.
4. Transcribe eligibility information to your record system fields.
The details in the summary will vary based upon the payer (insurer), and may require some interpretation to enter into your health record system’s fields.
For sync customers, the patient’s eligibility information is not written to your practice management system (the Eligibility PDF will still sync to the patient chart).
Understand insurance status
Patients scheduled for each day appear on your NexHealth Home page. The Insurance column highlights patients’ verification status.
The Insurance status is displayed as one of four icons.
Grey clock = insurance verification is pending (the appointment is not yet in the window, or has not yet been verified)
Green checkmark = insurance verification has been completed and the coverage is Active, or the patient has been marked as Self pay.
Orange caution triangle = insurance verification has been attempted, but there is an issue. This may say Investigate, or Unknown. Opening the patient's chart will usually provide additional information and steps to resolve the issue.
Grey circle with a dash = insurance is Inactive, Unverified, or verification Failed.
For specific coverage information, click the patient’s name to open their profile.
Click the down arrow in the Insurance Eligibility area to reveal the status of the patient’s verification and access the Eligibility PDF. |  |
Supported payers
NexHealth can verify over 1,200 payers. To understand if NexHealth's Verification is a good fit for your practice, navigate to NexHealth’s list of supported payers and enter the insurance carrier by name or ID in the search bar.
Does the payer appear? If so, we should be able to verify insurance for patients with that carrier. The information provided in the Eligibility PDF varies by payer, but we will always return all of the information that we receive.
If the payer is not there, use can request that we add a payer to our database.
We will take all requests under consideration, although we can not promise a timeline or that we will be able to add them.