NexHealth can automatically verify insurance eligibility before every appointment, so your team doesn't have to run checks manually. This article explains how automated verification works, how to set it up, and how to interpret results.
This feature requires NexHealth Verification.
How automated verification works
NexHealth checks each patient's insurance eligibility automatically when their appointment enters the verification window — by default, 7 days before the appointment date, or on the first day of the appointment month, whichever is later.
Verification runs once per appointment. If a patient has two upcoming appointments, verification runs separately for each one. This is expected behavior, not an error.
NexHealth always uses the most recently updated insurance information available for each patient, from whichever source was updated last:
Insurance synced from your health record system (Dentrix, Open Dental, and Eaglesoft only)
Insurance submitted by a patient via a NexHealth insurance form
Insurance entered manually during an on-demand verification
If you need to update insurance information before verification runs, see How do I update patient insurance information for verification?
Set up automated verification
Step 1: Set your verification window
The verification window controls how far in advance NexHealth checks eligibility. The default is 7 days. To change it, go to Verification settings in NexHealth. See Can I customize the verification window?
Step 2: Monitor upcoming verification statuses
Check the Needs attention tab in Verification daily to catch any issues before appointment day. Appointments added less than 7 days in advance are verified within about two hours of being scheduled.
Best practices
Update insurance information promptly whenever a patient provides new details.
For patients with multiple plans, confirm the correct primary plan is marked in your health record system.
Review the Needs attention tab before each day's appointments.
FAQ
What triggers automated verification?
NexHealth triggers verification 7 days before an appointment, or on the first day of the appointment month, whichever is later. You can adjust this window in Verification settings.
When will verification run for a specific patient?
The Scheduled tab in Verification lists all upcoming verification checks. From the ellipsis [...] menu, you can also verify on demand or change eligibility status.
Will verification run more than once for the same patient?
Yes — verification runs once per appointment, not once per patient. If a patient has two appointments scheduled, verification runs for each appointment separately. This is by design and ensures each appointment has a current eligibility check.
If you see a verification with no obvious upcoming appointment, the appointment may have been cancelled. To check: click the patient's name to open their Patient 360 sidebar, then review the Appointments section for any cancelled appointments that may have triggered the check.
Where can I see a patient's verification history?
Go to the Complete tab in Verification and search for the patient. You can view or download their full verification history, open eligibility PDFs, or update the status for appointments more than 24 hours past.
Where can I see verifications that need attention?
The Needs attention tab in Verification shows all failed or inconclusive verifications for upcoming appointments and for appointments within the past 24 hours. Use the Resolve button to verify on demand, or the ellipsis [...] to manually update eligibility status.
What prevents automated verification from running?
Automated verification cannot run if insurance information is missing or incorrect in your health record system. Update the patient's insurance details and run an on-demand verification if needed.