For use with NexHealth Verification and Forms
Before running Verification checks, you will need to set up your Verification feature.
Syncing insurance information from your health record system is only available for customers syncing with Open Dental, Dentrix, or Eaglesoft.
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Overview
FAQ
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.
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 syncing with Open Dental, Dentrix, or Eaglesoft.
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. Eligibility Summary PDFs 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.
This PDF can also be accessed from the Complete tab within Verification (this only happens if the verification is successful; we will not sync PDFs for unsuccessful verifications).
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.
The patient’s eligibility information is not written to your practice management system (the Eligibility PDF will still sync to the patient chart).
FAQ
What do the insurance statuses mean?
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. |  |
What payers does NexHealth support?
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.
See also
Enter or update insurance information - Manually enter or update insurance information for a patient.
Automatic verification window - When and how NexHealth verification runs automated verification checks.
Manual verification on demand - Manually run verification checks for patients outside of the automated windows.
Override verification status - Override verification statuses or mark patients as self-pay.