How to Use the eVerifications Service

 Related Training

Getting Started with eVerifications Recorded Class

Use the Sensei Cloud eVerifications service to perform real-time eligibility checks and eClaim Status verifications for insurance payers that participate.

The service retrieves the requested information and then:

• Displays the documents in a new browser tab
• Saves them as .html files to the patient's Files list (Patient tab > Patient Files).

Important: If your browser settings do not allow pop-ups or redirects, the file is saved directly to Patient files. You can allow pop-ups when prompted, but it is recommended that you keep the "don't allow sites to send pop-ups or redirects" setting, and add an exception for the Sensei Cloud URL.
  1. Select Settings > Security and Privacy > Site Settings > Pop-Ups and Redirects.
  2. Select Don't allow sites to send pop-ups or use redirects.
  3. Next to Allowed to send pop-ups and redirects, click Add.
  4. Enter https://gosensei.us and click Add.

When you enroll in this service, a Carestream Dental representative will enable it for your practice. Once enabled, the relevant controls become active throughout Sensei Cloud. 
Note: To verify the feature is enabled for your practice, click the User menu.

Eligibility

Click Check Eligibility to verify the patient's coverage in real time. The service displays the patient's Eligibility & Benefits document in a new tab, where you can view the file to verify coverage. When you close the tab, the document is saved to the patient's Files list. Click Download File to view it from this list.

When the patient's insurance payer participates in eVerifications, the link is active in the following locations:

• Patient tab > Home
  
• Patient tab > Patient Record > Insurance Information
  

Note: You can also access the link from the Patient mini card as well as the Update Insurance Policy window when you update a patient's policy (Edit Patient Record > Insurance Information > Edit).

Important: An error message is displayed when you click Check Eligibility if certain information does not match the insurance payer's records, including:

• Patient Name
• Patient Date of Birth
• Patient Insurance Policy Subscriber ID
• Provider Tax ID Number (TIN)
• Provider NPI Number

For example, minor discrepancies such as the patient name being recorded as "Jon Smith" instead of "John Smith" can trigger this error. Be sure to verify that all of the preceding items match the information in the insurance payer's records. 

Claim Status

Click Check eClaim Status to view the real-time status of an individual claim with a participating payer. The service displays the eClaim Status in a new tab; when you close the tab, the document is saved to the patient's Files list. Click Download File to view it from this list.

The link is found in the following locations:

• Location > Claims > Claims Management > [select claim] > Claim Summary
• Patient > Insurance Claims Management > [select claim] > Claim Summary

Insurance Payers

To view whether a payer supports one or both of these options, select Administration > Insurance > Payers. The Insurance Payers list displays two eVerifications columns for each payer:
- Eligibility (Yes/No) and - Claim Status (Yes/No).