e-Service, Eligibility

by Larry Emmott on June 10, 2011

in e-Services,Internet,Management

I find that the majority of dentists under utilize e-services. For the most part I believe this is simply because they are not aware of the service and how easy it is to use. As a general rule an e-service is online, uses digital information and is automatic. That is once you set up the service it runs automatically by itself, no humans involved.

This is possible because the service uses digital information. We gather this digital information as a byproduct of doing business with a computer. For example; the patient’s name, their insurance carrier and there next appointment. Once this is gathered in a digital format it is accessible to a computer and can be used automatically with no additional involvement of a human being.

A good example is the Dentrix eligibility checker which is part of the Insurane Manager linked below. In the recent past and sadly the here and now in many offices checking on a patient’s insurance coverage and eligibility started with a phone call to an 800 number. After negotiating a press one for this and two for that maze the caller settled in to a long wait listening to on hold muzak. After twenty to thirty minutes a human from the insurance provider finally talked to the human in your office, some information was exchanged scribbled onto a chart then typed into the insurance record.

The same thing can be done as an e-service. Your office computer has the digital information. That is a patient name, an appointment date, a scheduled treatment, the insurer and plan number. The e-service extracts the pertinent information from your local computer, contacts the appropriate insurance computer through the Internet and extracts the pertinent data from the insurance computer. That is; is this patient covered for this treatment and what is the coverage?

The e-service will then go back to your local office computer and download the information sometimes even going so far as to insert the data in the proper charts and appointments. So every day you can look ahead to the next day and know who and what is covered with no staff time, 800 numbers or muzak.

And you can do it all for a small monthly fee that is usually less than two hours of staff time. You just need to do two things to make this possible. Gather digital data and sign up for the service.

The Insurance Manager can automatically collect insurance eligibilities in advance of an entire day’s worth of appointments.

via eCentral Insurance Manager for Dentrix.

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{ 2 comments }

Steve Walkenshaw January 28, 2011 at 5:02 pm

It would be nice if it worked that way every time, but there is no cure all for eligibility. I have yet to see a service that gets the information right all the time. Many times a phone call has to be made because eServices can’t verify the eligibility. This article makes it sound like eServices works 100% of the time, but it doesn’t. Don’t let this article fool you.

Larry Emmott January 31, 2011 at 9:51 am

Good point Steve. The fact is that some third parties do not offer automatic online eligibility so it is not 100% reliable.

However my primary point is that the service exits, it works most of the time, when it does it is a huge time and money saver and most dentists are not even aware it is available.

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