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EDM > Dentrix Enterprise - Reference Guide: Insurance Verification

Keeping track of all the new icons and processes when starting with Zuub can be difficult. Here is a resource that tries to get all the information for you to reference in place.

Quick Links:

Glossary
Insurance Verification Icons
Common Errors
Write-back
Top Payers
Manual Verifications
Sync Times
Hard Refresh
Resources

Glossary

API - Insurance Payer controlled channels where information updated and released to third parties such as Zuub. The information Zuub presents is limited to the data that is published in these channels.

Bot - Zuub built solutions that pull information directly from Insurance Payer portals. Credentials need to be added and maintained within the Zuub Portal for these solutions to work properly.

Combined - A combination of Bot and API solutions, where Zuub attempts to pull the information via the Bot process first, if not available, then Zuub attempts to pull the information via API.

Data Bot - Verification pulled via Insurance Payer Portal and presented in a Zuub standardized format.

PDF Bot - Verification pulled via Insurance Payer Portal and presented in a PDF format.

Write-back - Data being written back into the fields within Dentrix Enterprise.

P - Primary Insurance

S - Secondary Insurance

See Verification - This verification was pulled as a PDF breakdown. In order to see the status of the insurance you have to click into the patient ID and look at the actual breakdown.

Insurance Verification Icons

Icon Name Description
Solid Blue P Verification went through successfully. Zuub was able to retrieve information on the patient.
Solid Blue S Verification went through successfully. Zuub was able to retrieve information on the patient.
Solid Red P Verification did not go through successfully. Zuub was not able to retrieve information on the patient.
Solid Red S Verification did not go through successfully. Zuub was not able to retrieve information on the patient.
Solid Light Blue P Patient has not been verified by Zuub.
Solid Light Blue S Patient has not been verified by Zuub.
Filter Function Found in the schedule view, the Filter Function, lets you filter your schedule by verification status, error, payer, and/or provider.
Loading Wheel Found in the Insurance Verification tab, this appears when you are manually running verifications on a patient and the verification is taking a little longer to pull back a breakdown. When this appears next to the patient's name in the Recent Verifications field, that give you the confirmation to be able to clear the manual form to search another new patient while the verification is completed for the initial patient.

Common Errors

Error: "Invalid username or password."
Cause of Error(s): Password or username needs to be updated.

How to Resolve: Check password by logging onto the Insurance Payer portal. Then navigate to Zuub > Settings > Insurance Verification > General Settings and find the Insurance Payer in the list, select "edit" and update the username and/or password.


Error: "Account is locked."
Cause of Error(s): Password was not updated and multiple attempts to log in to pull verification breakdowns resulted in account being locked out.

How to Resolve: Follow protocol to unlock Insurance Payer accounts. I.e. reset password, call Insurance Payer, etc. Once password is reset, log into the Zuub Portal and update password for all affected accounts.


Error"Unable to respond."
Cause of Error(s): The Insurance Payer’s API or website was overloaded at the time the verification ran. Manually running the verification again should resolve the issue.

How to Resolve: On the Schedule View, manually run the verification again by clicking the three dots on the far right of the patient's information and selecting "Verify Now."

Write-back

There are seven fields that are currently eligible for write-back. At this time, below are the fields that are enabled.

Additional information on where the data is written back into Dentrix Enterprise can be found in the following resource: Dentrix Enterprise (DxE) Write-back

Top Payers

Connection Type Workflow

When Zuub runs verifications, certain information from Dentrix Enterprise is utilized to bring back a successful verification. Below is a breakdown of the specific data points that are used.

Connection Type Workflow
API

First Name, Last Name, DOB, Member ID, Group ID, Insurance Payer and Provider are all submitted to retrieve a breakdown.

Bot Cigna
Member ID is submitted to retrieve a breakdown.
If that doesn't work, then First Name, Last Name and DOB are submitted.

Delta Dental
Member ID and DOB are submitted to retrieve an insurance breakdown.
If that doesn't work, then First Name, Last Name and DOB are submitted.
Note: If either comes back with results in the Payer Portal with a Group ID present and there's more than one result, then Zuub matches on Group ID.

Pending

Combined First Name, Last Name, DOB, Member ID, Group ID, Insurance Payer and Provider are all submitted to retrieve a breakdown.

Top Payer Overview

Payer

Connection
Type

Information Provided Write-back Eligible
Aetna API Eligibility, Maximum, Remaining Maximum, Deductible, Remaining Deductible, Coverage Table, Orthodontics, Common Procedures, Frequency, History, Payer ID, Employer Name, Group Number Yes

Cigna

Combined Eligibility, Maximum, Remaining Maximum, Deductible, Remaining Deductible, Coverage Table, Orthodontics, Common Procedures, Frequency, History, Missing Tooth Clause, Waiting Periods, Payer ID, Employer Name, Group Number Yes

Delta Dental

API Eligibility, Maximum, Remaining Maximum, Deductible, Remaining Deductible, Coverage Table, Orthodontics, Common Procedures, Frequency, Employer Name, Group Number

Disclaimer: Other fields vary, so please refer to What Zuub Pulls on Insurance Top Payers.
No

Delta Dental

Bot Eligibility, Maximum, Remaining Maximum, Deductible, Remaining Deductible, Coverage Table, Orthodontics, Common Procedures, Frequency, Employer Name, Group Number

Disclaimer: Other fields vary, so please refer to What Zuub Pulls on Insurance Top Payers.
No

Delta Dental

Combined Eligibility, Maximum, Remaining Maximum, Deductible, Remaining Deductible, Coverage Table, Orthodontics, Common Procedures, Frequency, Employer Name, Group Number

Disclaimer: Other fields vary, so please refer to What Zuub Pulls on Insurance Top Payers.
No

United Concordia

Combined Eligibility, Maximum, Deductible, Coverage Table, Orthodontics, Common Procedures, Frequency, History, Missing Tooth Clause, Paid on Date

Disclaimer: Downgrades and Coordination of Benefits may differ based on plan, so please refer to What Zuub Pulls on Insurance Top Payers
Yes

Delta Dental → API: Oklahoma and Washington

Delta Dental → Bot: Delta Dental, Colorado, Idaho, Illinois, Iowa, Kansas, Massachusetts, Missouri, New Jersey, Northeast (Maine, New Hampshire, and Vermont), Oregon, Virginia, Wisconsin

Delta Dental → Combined:

  • DDIC (Alabama, California, Delaware, Florida, Georgia, Nevada, Louisiana, Maryland, Mississippi, Montana, New York, Pennsylvania, Puerto Rico, Texas, Utah, Washington DC, West Virginia)
  • Delta Dental Toolkit (Arizona, Arkansas, Indiana, Kentucky, Michigan, Minnesota, Nebraska, New Mexico, North Carolina, Ohio, Tennessee and Federal Plans)

Please Note: For additional information regarding these payers or any other payers, please reference the following document: What Zuub Pulls on Insurance Top Payers

Manual Verifications

Schedule View: Navigate to the date the patient is scheduled. Find the patient on the schedule, and scroll to the right hand side of the patient's information to click on the three dots. Click on the three dots and select "Verify Now" from the dropdown.

Please note: Verifications done this way will be based on the Provider indicated on the appointment and the notes will be written back to the appointment notes.


Patient Look-up: Navigate to the "Search for patients" field at the top of the Zuub Portal view and start typing in the patient's name. A list will populate, where the correct patient can be selected. Once selected, the patients breakdown will be presented, where you can select "Verify Benefits" and verify the patient without having to add them to the schedule.
Please note: Verifications done this way will be based on the Default Provider unless another individual is selected from the Provider dropdown in the Zuub Portal. Notes will be written back to patient notes.


Insurance Verification Tab: Navigate to the Insurance Verification tab in the Insurance Verification module. This will display a manual form that can be used to verify patients. This tab should only be used for patients that are not of record, as nothing is written back or uploaded into your Dentrix Enterprise, even if there are successful verifications from this tab.

Sync Information

Field Type Sync Type Cycles Paramaters
Appointment Details

Dentrix Enterprise > Zuub

3 to 5 minutes N/A
Patient Details Dentrix Enterprise > Zuub 3 to 5 minutes N/A
Insurance Details Dentrix Enterprise > Zuub 30 minutes N/A
Write-back Zuub > Dentrix Enterprise > 30 minutes Uploaded once a day**

*If you are manually re-running a patient and a PDF was already uploaded in the last 24 hours, you will need to manually download the breakdown from Zuub and upload it into Dentrix Enterprise.

**If you are manually re-running a patient and a note was written back the day before, you will see another note write back into Dentrix Enterprise.

Hard Refresh

If there is a delay in your schedule view or while you are, please follow the steps below to perform a hard refresh.

Best Practices

Coming Soon

Resources

How-To: Find Your Zuub Account ID

 


This resource was updated 4/23/2024.