NexHealth Verification automatically:
Syncs insurance information from your health record system
Automatically verifies coverage for upcoming appointments (default: 7 days before the appointment)
Creates an Eligibility PDF only when active coverage is confirmed, showing complete benefit details (deductibles, procedure coverage, network benefits, etc.)
You can also verify insurance:
Using our Dental Insurance Verification form for automatic verification
Manually entering patient insurance details when needed
If you do not yet have Verification, navigate here to click the Get a demo button. Someone from NexHealth will be in touch!
Select Verification method
Fully integrated systems (Dentrix, Dentrix Enterprise, Eaglesoft, and OpenDental)
Set the destination folder for your Eligibility PDF sync
Optional: Adjust the verification window (the default is 7 days before appointments). Verification begins automatically when an appointment enters the verification window
Optional: Set up smart form rules to send the Dental Insurance Verification form automatically or add the Dental Insurance Verification form to packets and/or templates
Partially integrated systems using NexHealth integrated forms
Set the destination folder for your Eligibility PDF sync
Optional: Adjust the verification window (the default is 7 days before appointments).
Optional: Set up smart form rules to send the Dental Insurance Verification form automatically or add the Dental Insurance Verification form to packets and/or templates
Verification will happen automatically based on information on the Dental Insurance verification form when the appointment enters the verification window, or immediately upon receipt if it is already in the window
Non-insurance integrated verification without forms (manual on-demand verification)
Manage Verification
Set location for Eligibility PDFs
*Note: This feature is only available for systems with NexHealth's integrated forms.
1. Navigate to the gear icon and choose Settings.
2. Select Eligibility PDF sync.
3. Select the Eligibility PDF destination folder from the drop-down menu (if you do not see yours listed, ask your Onboarding Manager, or contact Support).
4. Adjust your Sync preferences (if desired). Automatic syncs the Eligibility PDF to the patient chart in your health record system. Manual allows you to review the PDF before downloading it and uploading it into your health record system.
Change Verification timeframe (optional)
1. Select Verification window from the left side menu.
By default, verification is set to run 7 days before a patient's appointment.
2. Click Edit to adjust the window.
3. Click Save.
4. Adjust Dynamic windowing if desired. Dynamic windowing adjusts your standard eligibility window for appointments scheduled early in the month to ensure you have the most up-to-date insurance information.
Set verification limit
Your NexHealth subscription includes 800 verifications per month. After 800, each additional verification is $.20. You can allow overages by navigating to Settings --> Usage management and toggling ON the Allow overages toggle.
Add Provider information (optional)
Adding a Global NPI and Tax ID ensures that provider data pre-fills for each verification, reducing manual entry for On-Demand checks, and ensuring that verification happens automatically from the Dental Insurance form. (Note: providers can still modify the NPI and Tax ID on the On-Demand form if needed.)
1. Select NPI and Tax ID from the left side menu.
2. Click on Use single global NPI and Tax ID.
3. Enter the Provider Name, NPI, and Tax ID you want to use for verification.
4. Click Save.
Run manual verifications
Select the patient from the Home page appointment list, or use the search bar to locate the patient's chart in NexHealth.
Click on the patient's name to open the profile.
Open the Insurance tray by clicking the down arrow.
Choose Verify eligibility on demand.
5. Complete the required information for the patient and click Verify. The patient's Insurance eligibility will be returned within seconds!
When patient information for verification is entered manually, if an error is returned with instructions to resolve the issue, the patient's insurance information will be prefilled after making the corrections, so you do not have to enter it again.
NexHealth will store that patient's insurance information so the next time the patient has an appointment, the information will not have to be re-entered (as long as their insurance info has not changed), and their insurance will be automatically verified when the appointment enters the verification window.
You can manually run a verification of a patient's primary or secondary insurance anytime.
Understand insurance status
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.
Mark patients as Self pay
Patients without insurance can be marked as Self pay to ensure their insurance status on the Home page does not cause unnecessary work or count against your monthly verification limit.
Open the patient’s profile.
Expand the Insurance Eligibility drawer by clicking on the down arrow to the right.
Select Change eligibility status.
4. Choose Self pay.
5. Click Save.
The patient's status will appear as Self pay:
