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How do we setup our office for Enhanced Eligibility? (Currently in Beta)

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Jaclynn
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Introduction:
Denticon's Enhanced Eligibility tool allows your office to streamline patient insurance verification, powered by advanced DentalXChange Eligibility AI. This tool automates insurance verification, eliminating the need for time-consuming phone calls and manual portal navigation. With Enhanced Eligibility, your practice can increase efficiency, reduce errors, and enhance patient experience by ensuring accurate, up-to-date coverage information at every step. Offices using Enhanced Eligibility will no longer rely on the nightly RTE process to retrieve eligibility from DXC. This guide will serve as a reference to help you with the setup process.

Process description:
The process includes two parts: setup on the DXC Eligibility AI portal (payer credentials) and Denticon configuration. 

Prerequisites:
In order to perform the Enhanced Eligibility configuration in Denticon users will need the following security rights:

  • Setup-Account Screen Full Control
  • Setup-Office Screen Full Control

Before going live, office level credentials must be set-up for each payer within the DentalXChange Eligibility AI portal​. 

Gathering materials/resources:
You will need to gather the usernames and passwords for your insurance company portals. These credentials enable the eligibility platform to connect to the payer's system to retrieve benefits.

Step-by-step instructions:

Configuring Enhanced Eligibility in Denticon

How to enable Enhanced Eligibility for the PGID:

  1. Go to Setup>Account Info>Advanced
  2. Click the "Edit" button. 
  3. In the section labeled "Third Party Settings" check the box for Enhanced eligibility. 
  4. Press Save. 

A screenshot of a computer AI-generated content may be incorrect.

How to update the RTE automated eligibility setting at the office level:

  1. Go to Setup>Offices>Office Setup>Advanced.
  2. Click the "Edit Office" button.
  3. Set the field for "# of Days Before Appt to Check Eligibility" to 0.
    1. This ensures that enhanced eligibility records are not overwritten with DXC’s RTE service.
    2. RTE can still be used on-demand if needed.
  4. Press Save.

A screenshot of a computer AI-generated content may be incorrect.

How to add DentalXchange Eligibility AI as an API vendor:

  1. Go to Setup>Offices>Vender API Settings-New.
  2. Click the "Add Vendor" button.
  3. Select "DentalXChange – DXC Enhanced Eligibility AI (DXC)"

    1. Activating does not complete the process. The activation will send a notification to DXC. DXC will then link that office to their Eligibility AI portal. 

 

Configuring Enhanced Eligibility via the DXC Eligibility AI portal

Please note, the following steps will initially be completed by DXC during the onboarding process. 

  1. Go to Utilities>E-Claims Management to access DXC's merchant portal, click the tab labeled "Dashboard".
  2. Select the option for Eligibility AI.
  3. On the left-hand side of the screen click the "Administration" tab.
  4. Select the tab for "Schedule Settings"
    1. This is where you configure the Eligibility AI platform to automatically pull eligibility for patients.
  5. Select the number of days (1 to 7) before an appointment you would like the checks to be run.
  6. Click the "Payer Credentials" tab. 
    1. In this section, you will add the usernames and passwords you have for the various insurance company portals. This is what will allow the eligibility platform to connect directly to the payer's system when it attempts to pull benefits.
    2. Here you will see the payer the credential is for, the website being used for the eligibility checks, username and password for the payer's site, the date/time the credentials were last updated, and a number of action buttons. 
      1. The "Eye" button will show the saved password for the payer's site.
      2. The "Double-Page" button allows you to use those same credentials for a different payer.
      3. The "Pad and Pencil" button will let you edit the saved username and password for a payer's site.
      4. The "Trashcan" Button will delete the saved credentials for a payer's site.
    3. If there are multiple payors that use the same website, they will be grouped together, and you will only need to enter one username and password. 

How to add payer credentials with multi-factor authentication:

  1. Some payers that support enhanced data with Eligibility AI require multi-factor authentication (MFA) when adding the credentials to your account. Logins that have MFA will generally ask you to provide some sort of code in addition to the username and password. The most common form of this is sending a code to the email or phone number on file for that payer's website.

  2. Add the credentials for the desired payer by clicking the "New Payer Credential" button.
  3. Enter in your username and password and press the "Add Credential" button. 

  4. Once the credentials are verified you will then be given the window to add your MFA code. You will then access your code from whatever delivery method the payer's site uses, and enter it here.

    1. If you are unsure of where this code is delivered, log in to the payer website directly on their portal. Oftentimes, their site will display the email or phone number used for MFA. For the smoothest experience make sure you are aware of the MFA process for the payer you are trying to add. Once you begin you will have 180 seconds to enter in your MFA code.

  5. Once you have successfully entered the MFA code, Eligibility AI will store the session for up to 30 days. This means that you will not have to re-enter the MFA code until the session expires.

  6. Once a stored session has expired, you will need to enter a new MFA code. The appointment will state "invalid credentials". Navigate back to the "Payer Credentials" tab. Click the pad and pencil action button, then click "Update Credential". This will generate a new MFA code to be sent as well as reopen the window to enter in the new MFA code. 

How to generate an API Key:

  1. Navigate to "Connectors" tab.
  2. Click the "New Connector" button and select your software, OID and PGID to generate the key.

  3. There are also action buttons on this page as well:

    1. The "Eye" button will display the API Key.

    2. The "Double-Page" button will copy the key to your clipboard.

    3. The "Trashcan" button will delete the key. Use caution when deleting an API Key. If you delete a key that is currently used to sync your appointments in Denticon, you will need to contact DXC support to reconnect to Denticon. 

Additional information:
The following carriers are currently available for Enhanced Eligibility:

What payers are eligible for Enhanced Eligibility via DXC's Eligibility AI? (Currently in Beta)

 

 

 

 

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