For use with NexHealth Verification
To ensure accuracy, NexHealth always verifies insurance using the most recently updated insurance information available for each patient. Our system is designed to automatically identify and use the latest insurance details, regardless of how they were submitted.
If you need to update patient insurance information, see Update patient insurance info.
If you need to verify immediately, see Verify on demand.
If you need to override eligibility status or mark a patient as self-pay, see How to override eligibility status.
Overview
Keep records up-to-date.
Correctly mark primary insurance plans.
Preview insurance verification for upcoming appointments.
Running automated verification checks
Let NexHealth automatically run verification checks for upcoming appointments.
1. Set the verification window.
The verification window is the time ahead of the appointment when NexHealth will automatically verify insurance eligibility. The default is 7 days ahead of each appointment, but you can change the verification window.
2. Allow appointments to enter the verification window.
NexHealth will then automatically verify insurance eligibility for you. Each time a new appointment enters the verification window, we’ll re-verify the insurance for you.
NexHealth will always use the most recently entered insurance information, regardless of which of these three sources it comes from:
Synced information from your health record system (available only for Dentrix, Open Dental, and Eaglesoft customers).
Information submitted by patients via the Dental Insurance verification form.
Manually-entered information from requests to Verify eligibility on-demand.
3. Monitor upcoming appointments’ verification status.
Each day, check upcoming appointments’ verification status to catch any potential issues. In the Verification page, you can see all verifications which need attention in the Needs attention tab.
Best Practices
To ensure optimal insurance verification:
When collecting new insurance information, promptly update it in your systems.
For patients with multiple insurance plans, always make sure the correct primary plan is marked in your EHR.
Review verification results before appointments to catch any potential issues
FAQ
What triggers automated verification?
NexHealth will automatically trigger verification checks 7 days before an appointment, or after the first day of the month of the appointment, whichever is later. You can adjust the verification timing in settings.
When will verification run for a patient?
The Scheduled tab within Verification will show you a list of all scheduled, upcoming verification checks. From the ellipsis [...] there, you can also Verify on demand or change eligibility status.
Where can I see history of verifications for a patient
In the Complete tab within Verifications, you can search for patients and see or download their history of verifications. You can also use the ellipsis [...] to view the eligibility PDF for a successful verification or to update verification status for failed verifications for appointments that are more than 24 hours past.
Where can I see successful verifications?
A list of successful verifications will be shown in the Complete tab within Verifications.
Where can I see failed verifications? How do I address failed verifications?
You can see a list of all failed verifications for upcoming appointments and for appointments within the past 24 hours in the Needs attention tab in Verification. You can use the Resolve button to Verify on demand and manually address errors, or you can use the ellipsis [...] to manually update their eligibility status.
What prevents automated verification?
Automated verification may be prevented by out-of-date or incorrect information.
Does automated verification re-run?
Automated verification will re-run for each of a patient's appointments.