Insurance Verification Configuration Guide

  • Insurance Verification seamlessly examines your patients’ insurance eligibility and delivers comprehensive data ahead of their appointments, all within the RevenueWell Marketing Platform system.

    Gone are the days of juggling calls to various insurance providers or navigating multiple carrier portals. With Insurance Verification, you have the option to conduct checks directly within RevenueWell, providing you with dependable data that you can confidently communicate to your patients.

    As you get started with Insurance Verification, here are some important terms to know:

    1. NPI (National Provider Identifier): A 10-digit unique ID assigned to healthcare providers in the U.S. to streamline electronic transactions like insurance claims.

    2. Payer: An entity responsible for processing and paying claims for healthcare services, including dental, such as insurance companies or government programs.

    3. Provider: Individuals or entities, like dentists or dental practices, delivering healthcare services covered by insurance plans.

    4. Defining a Relationship: Process by which a dental provider establishes a contractual or professional tie with a dental insurance payer, involving documentation submission.

    5. PMS (Practice Management Software): Software tailored for managing dental practices, covering tasks like appointment scheduling, billing, and insurance claims processing.

    Ready to streamline your verification process? Onboarding for Insurance Verification (IV) is designed for self-setup at your convenience. Here's a quick overview of how you can set up Insurance Verification:

    • Access Settings: Start by navigating to the Settings section within RevenueWell. You can do this by clicking on the gear icon.
    • Select IV Settings: Once in the Settings menu, locate and select your new Insurance Verification settings option. This is where you'll configure all the necessary parameters for IV.
    • Welcome Screen: When you first use Insurance Verification Settings, you'll see a "Welcome" screen. It lists necessary onboarding info like National Provider Identifiers (NPIs) and shows your providers by patient percentage.
    • Configuring Settings: To begin using Insurance Verification, it is required to configure all of your Insurance Verification settings. 

      This article serves as a comprehensive guide to walk you through each stage of the Insurance Verification onboarding process. By completing this process, you'll unlock the benefits of Insurance Verification with RevenueWell, streamlining your administrative tasks and enhancing efficiency.

  • Step 1: Payer Setup

    Let's get started!

    To begin the setup process for Insurance Verification, please follow the steps below:  
    1. Login to RevenueWell.
    2. Click the "Settings" gear icon. 
    3. Click "Insurance Verification" in the settings menu. 
    4. Welcome! Ensure you have the required information for each provider (50% patient coverage required at set up). 
    5. Multi-location offices will then see a list of offices within your organization and their current status. To begin onboarding, click on the pencil icon next to each office and continue with the steps below for each office.
    6. Click into the "Payer Setup" tab within your Insurance Verification settings. 
    7. Select "Edit" next to the payer to begin setup. 
    8. Here you will see a screen with three (3) options:
      1. Option 1: Setup Payer - Initiates the primary flow to set up a new payer.
        1. Attach identifier to payerID: Choose from the list the Payer and their corresponding PayerID associated with their Insurance Identifier.


          If a Payer in the list has already been set up, you will see "SELECT (EXISTING)." Choosing this option will link the insurance identifier to the previously set-up Payer.

        2. Define relationship(s): Define the default relationship with the Payer and any provider exceptions. Provider exceptions occur when a specific provider at the practice has a different relationship with the Payer than the practice itself. When adding a provider exception, select the provider from a dropdown menu and the applicable relationship type accepted by the Payer.


        3. Portal Credentials [Pro]
          • 3a: Add payer portal credentials (Pro supported portals only): If the Payer's provider portal is supported, the setup process continues with this screen. Enter username and password to connect the provider portal.
          • 3b: Portal URL and Username/Email Conflicts [Pro]: Potential conflicts may arise when an office must correct the Username/Email for a specific portal before providing their password and continuing.
            • "Username/Connection Exists" (blue) - Indicates when the Portal URL and the Username/Email match an existing connection. To proceed, the practice can choose the "Use Existing Connection" button or adjust the Username/Email.
            • "Connection Exists" (red) - Indicates a rare occurrence where the exact Portal URL and Username/Email combination exists outside the practice's organization. To move forward, you must correct the Username/Email.

          • Step 3c: Payer portal connection statuses [Pro]: Once portal credentials are submitted, the system attempts to connect to the portal, displaying one of the following statuses:
            • "Connecting" - Establishing connection to the portal.
            • "Invalid Credentials" - The username and password combination was invalid.
            • "Connected" - Successful connection to the provider portal. At this point, the Payer setup is complete (unless the Payer is Medi-Cal).
        4. Add payer NPI Override (Medi-Cal only): For Medi-Cal, two additional pieces of data, NPI Override and PIN, are required.

        Watch our demo video for setting up an insurance identifier as a payer here! 🎬

      2. Option 2: Link to Existing Setup - This enables you to associate this Insurance Identifier with an already established payer setup.

        Watch our demo video for linking an insurance identifier to an existing payer here! 🎬

      3. Option 3: Set as Auto Self Pay - Allows you to designate this insurance identifier for Self Pay.
    9. Repeat these steps for each payer you wish to connect to RevenueWell.
    10. Once you have complete payer setup, go onto "Provider Set Up."

    Watch our demo video for marking an insurance identifier as an indicator of self pay here! 🎬

  • Step 2: Provider Setup 

    To conduct insurance verification effectively, it's essential to input the National Provider Identifier (NPI) for each provider within the practice.

    To complete your provider setup: 
    1. Click "Provider Setup" in the Insurance Verification settings. 
    2. Enter the NPI for each provider. 
    3. "Save" changes.

    For hygienists (providers), please select one of the primary doctor's National Provider Identifiers (NPIs) to input. For active office staff or office staff who are no longer with the practice, please select the NPI of an active practicing provider. Additionally, you can update this information in your Practice Management System (PMS) to ensure accurate and up-to-date records of providers.

    See our demo video for provider setup here! 🎬

  • Step 3: PMS Sync

    In the Insurance Verification Settings section, you'll find the "PMS Sync" tab, which allows for automated PDF writeback of insurance verification documents (provided your PMS supports this feature). Here, you can easily determine if the sync is active, view the designated user for PDF syncing, and identify the destination location.

    To see this:
    1. Click "PMS Sync" within your Insurance Verification Settings.
    2. Select "Edit."
    3. Toggle "Enabled" on/off. 
    4. Select the designated "PMS User" from the dropdown menu.
    5. Choose your desired "PMS Location" from the dropdown menu to dictate where PDFs will be saved.
    6. "Save" changes. 

    Check out our demo video for PMS sync settings here! 🎬

    Check out our resource "Patient Data Management Made Simple" for additional insights!

  • Carriers [Pro]

    RevenueWell’s insurance verification solution collects data from 300+ carriers. This list highlights carriers that need additional information to ensure high-level data for your practice. This includes details like network name, portal details, and login credentials.

    Carrier Alternate Names Provider Portal Link
    AARP Dental Insurance Plan
    Aetna Aetna DMO
    Aetna Aetna Medicare
    Aetna Coventry Health Plan
    Aetna Southwestern Bell Exec - Custom Care
    Aetna Choice Plus
    Aetna FlexCare
    Aetna Mail Handlers Benefit Plan - MHBP
    Aetna Marriott
    Aetna Preferred Dental Organization (PDO)
    Aetna Prudential Administered by Aetna
    Aetna TWR
    Aetna Varian Health Care Plan
    Aetna Bell Atlantic
    AFLAC New York
    Blue Cross Blue Shield of Illinois
    Blue Cross Blue Shield of Montana
    Blue Cross Blue Shield of New Mexico
    Blue Cross Blue Shield of Oklahoma
    Blue Cross Blue Shield of Texas
    Cigna Connecticut General (CIGNA)
    Cigna Continental Dental
    Cigna Equicor / Equitable
    Cigna Healthsource Provident
    Cigna Provident
    Cigna UFT Welfare Fund
    Cigna Banner Health and Dental
    Delta Dental of California
    Delta Dental of Colorado
    Delta Dental of Delaware
    Delta Dental Ins - Florida
    Delta Dental Ins - Georgia
    Delta Dental Ins
    Delta Dental of Idaho
    Delta Dental of Illinois
    Delta Dental of Indiana
    Delta Dental of Kentucky
    Delta Dental Ins - Louisiana
    Delta Dental of Maryland
    Delta Dental of Michigan
    Delta Dental of Minnesota 3M Dental Services
    Delta Dental Ins - Mississippi
    Delta Dental Ins - Montana
    Delta Dental of North Carolina
    Delta Dental of Nebraska
    Delta Dental of New Jersey
    Delta Dental of New Mexico
    Delta Dental Ins - Nevada
    Delta Dental of New York 32 BJ
    Delta Dental of Ohio
    Delta Dental of Pennsylvania
    Delta Dental of Puerto Rico
    Delta Dental of Tennessee
    Delta Dental Ins - Texas
    Delta Dental Ins - Utah
    Delta Dental of Virginia
    Delta Dental of West Virginia
    Dentaquest Dentaquest - TennCare
    Dentaquest Dentaquest - University of Arizona Health Plans
    Dentaquest Dentaquest - WI State Employees
    Dentaquest Dentaquest - Affinity Health Plan
    Dentaquest Dentaquest - Atlantic Dental Inc
    Dentaquest Dentaquest - California Dental Network
    Dentaquest Dentaquest - Grady Healthcare
    Dentaquest Dentaquest - Maryland Physicians Care MCO
    Dentaquest Dentaquest - PhysiciansCare MCO
    Dentaquest Dentaquest - TrumanCare
    Dentaquest Dentaquest - Cimmaron Health Plan
    Dentaquest Dentaquest - Lovelace Community Health Plan
    Dentaquest Dentaquest - Presbyterian Salud
    Dentaquest Dentaquest - Xantus Health Plan
    Dentaquest Dentaquest - Medicaid of Virginia, HealthKeepers Plus
    Dentaquest Dentaquest - Medicaid of Nebraska
    Guardian Managed Dental Care Network
    Guardian Dental Guard Preferred
    MetLife Metropolitan
    United Concordia Florida Combined Life
    United Concordia United Concordia - Dental Plus
    United Concordia Blue Cross of PA - Highmark
    Unum Colonial Life


  • Demo Videos

    View our demo videos below for additional guidance on every step of the onboarding process! 🎬

    • In this video we will dive into starting the onboarding process and setting up an insurance identifier as a payer. 

    • Check out this demo to see how to link an insurance identifier to a existing connected payer.

    • Watch this demo for a quick overview of setting up an insurance identifier as an indicator of auto self pay. 

    • See the video below for a tutorial of provider setup.

    • In this demo we will cover how to edit your PMS Sync settings.