GEHA Plans

Our team has identified and resolved an issue with inconsistent data from the clearinghouse for GEHA plans. Specifically, we have addressed discrepancies in group numbers, ensuring accurate support for the three main dental plans:

• AA-Standard

• AA-High

• Connection Dental Plus

While this fix resolves issues with the dental plans, please be aware that GEHA also offers medical plans with dental benefits. Support for these plans is forthcoming and will be available soon.

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VeriSmart Support for Open Dental 23.3
Now Supporting Open Dental 23.3

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Bug Fix for Outsourcing without Verifying
You can now outsource without performing real-time verification.

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Settings Window

If patient is inactive / terminated, set last eligibility date will be set based on the checkbox

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Schedule View

Performance improvement to load data faster.

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Additional bug fixes.
 

Enhancement to Automatic and Manual Selection Recommendations
We provide tooltips for every record in the schedule view that you can hover on the checkbox to see why the record was recommended.

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Renaming Import Button.
Import button with different Color as per verification status. Show Legend on the top of schedule view.

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Past Verifications on Patient View.
You can view all the verifications for the selected patient and import benefits.

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Fix for Limited Exams Sharing Frequency:
We've ironed out issues related to limited exams sharing frequency with other exams for OD version 23.2 and above.

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Improved Handling of Code-Related Caveats:
Ignore code-related caveats in plan notes when the code has no coverage.

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Fixed Issue With Type Of Outsourced verification:
Ensure accurate categorization with outsourced breakdowns now imported correctly as breakdowns rather than eligibility.

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Bulk Import Enhancement:
Import with ease by selecting only the records you need, providing greater control over your data imports.

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Fix for SS Crown Downgrades:
We've addressed issues related to SS crown downgrades for seamless processing.

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Ability to Save PDF to Specified Folder:
Save time and effort with the option to save PDFs to a specified folder for easy access.

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Additional bug fixes.
 

1. Fix for Automatic & Manual selections in Schedule View.

1. Fix PMS Last Benefits Date in Schedule View. This also fixes Auto / Manual selection of the records.
2. Fix for AnnualMax setting it to 0 when we cannot get Annual Max through clearing house.
3. Benefit year not update when the plan benefit year changes from service year to calendar year.
4. View Verification History for a patient and import benefits. Helpful when a verification is performed after it is being outsourced.
5. Manual Import of a verification in settings window. Helpful when patient information or plan information changes after outsourcing.
6. Faster loading of bulk import screen. Fix will import verifications for selected records instead of all records.
7. Import all codes/caveats as per in customization without a code change and software release.

1. "Limited Exam included in Oral Exam" fix to support code groups

2. Show Breakdown Status (Automatic, Completed, Outsourced) in Import Column

3. Enhance Automatic / Manual selection in Schedule View

4. Refresh button on Patient View.

1. Extend support for legacy Verrific. 

1. VeriSmart - Fix for Bulk Import. Shows verifications that were outsourced, completed and not imported.

2. Detailed View toggle on schedule view. Allow to set default view (detailed or simplified view) in the settings.

3. Declutter schedule view. 

1. You Spoke, We Delivered: We've Enhanced Schedule Filters

Based on your valuable feedback, we've refined the names of our schedule filters to make them more intuitive for your staff. Here's what you need to know:

Automatic Verifications (Formerly 'Smart'): Easily select patients due for electronic re-verification based on their last eligibility check.
Manual Verifications (Formerly 'Outsource'): Instruct our system to select patients whose insurance policies need additional manual assistance for comprehensive verification.
These updated names better reflect the functions of each filter, making it easier for your staff members to navigate and utilize VeriSmart's powerful features.

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2. We've Decided to Rename our Verification Types:
In our ongoing effort to align VeriSmart with your workflow, we've updated the names of our verification types:

Eligibility (Formerly 'Plan Data'): Commonly referred to as "ReVerifications" in previous versions, this verification type will focus on providing three main things.

1) Whether or not the plan is active, 2) Insurance/Deductible remaining, and 3) History.
Breakdown (Formerly 'Plan + Patient Data'): This type encompasses all available data processed according to your office's customizations, including eligibility information.

3. Exciting Addition: Bulk Import Feature for Open Dental Users!
We're delighted to announce that the BULK IMPORT feature is now available for all Open Dental users! This powerful addition streamlines your workflow, allowing you to import multiple verifications seamlessly. Enhance efficiency and save valuable time with this exciting feature.

4. View list of supported carriers on Help --> Settings --> Supported Carriers. The list shows carrier name, electronic Id and if they support electronic (real-time) eligibility.

Features & Fixes

1. Fix for Fillings substitution

2. Manually update to new version as an administrator

3. Show warning when outsourcing a verification which is already outsourced using Verrific program

4. Support for Open Dental version 23.3 

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Features & Fixes

1. Support for Limited Exam Frequency in Code Groups for Open Dental version 23.2. If limited exam does not share oral exam frequency, limited exam will be added to LimitedExam code group and oral exams will be added to ExamsExceptLimited. if they share frequency, oral exams will be added to Exam code group.

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Features & Fixes

1. Support Code Groups feature of Open Dental version 23.2

2. Fillings/Crown Downgrade bug fix.

3. Import only customized codes instead of all the codes (Portal Fix).

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We're thrilled to share some major updates and improvements that will elevate your experience with VeriSmart. Our commitment to providing a seamless and efficient verification process has led to significant enhancements under the hood. With that said, let's dive into the details:

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1. Fewer Verification Errors
We've been hard at work optimizing our system to reduce verification errors. Our team has implemented several behind-the-scenes improvements, ensuring a smoother verification process. Additionally, we're excited to announce a significant reduction in missing data, further enhancing the completeness and accuracy of your verifications.

(From now on, every time we can't complete a verification, you will see a pop-up letting you know exactly why the verifications failed) 

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2. Automatic Import of Electronic Verification Data
Introducing a game-changing feature: automatic import of electronic verification data from the clearinghouse. By establishing a software connection to insurance carriers, VeriSmart now seamlessly imports data directly into the insurance folder of Open Dental. All with one click for ALL the patients on the entire day. Just select all patients and hit 'verify selected' and head over to the images module. Under the 'insurances' folder, you'll see the pdf titled 'VeriSmart Clearinghouse'. 

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3. Partial Data Import
We understand the importance of flexibility in your workflow. That's why we've removed the requirement to complete a plan before importing data. Enjoy the freedom to import data at any stage, even if it's partially completed. This update empowers you to work more efficiently and adapt to your schedule. Whether there are 2 missing fields or 20, you now have the ability to preview the standardized pdf and import even partial data. So now you can import right away what we were able to find and decide if the missing fields are critical. If so, simply outsource. If the data is not critical for that patient, import the data and you're all set. Note that importing the partial data ALSO imports the standardized breakdown pdf into the insurance folder of Open Dental. 

(Screenshot)

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4. Temporary Halt on New User Data Entry
To ensure the highest data quality standards, we're introducing training courses for new users. Before entering data into VeriSmart, users at dental offices must complete these courses remotely.

While this temporarily affects new users, existing users can continue without interruption. The good news is that with the ability to import partial data, users can now import everything available and decide later if they need to fill in missing data, even outsourcing it to Verrific.

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5. Improvements in Patient Verification and Outsourcing (for Open Dental)
We've simplified the decision-making process for verifying patients and outsourcing. Our 'Smart' option automatically determines which patients require a full breakdown or re-verification. Meanwhile, the 'outsource' option intelligently selects verifications based on the configurations that you should outsource. Enjoy more control and efficiency in managing your verification workflow.

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We're confident that these updates will streamline your verification processes and contribute to a more efficient workflow. Thank you for choosing VeriSmart—we're committed to continuously improving your experience.

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Open Dental Plugin.

• Smart option in Selection Criteria section in Schedule View. This will select the records which require either a detailed breakdown/reverification based on the OD last benefit/eligibility date, carriers real-time eligibility support and more.

• Show Ins Remaining in settings window will show OD Insurance Remaining on Schedule View and Patient View.

• Appending Plan Note option in settings window allows you to either append or overwrite plan note upon importing detailed breakdown.

• Bug fix in Bulk Import Screen to show all submitted verifications.

Backend

• Bug fixes for OON importing benefits, fields greyed out, not able to submit verifications

• Additional customizations were added to the list of global customizations. Now if you go to 'form customizations', you will find a lot more fields that you can enable and further customize your breakdown form! 

• Added real-time adaption for Humana, United Concordia, DD of PA

• Enhanced real-time support for Metlife, Aetna

• Ability to change carrier/group number in the backend after verification is outsourced to avoid creating new verifications.

• Bug fixes in Pdf to show proper downgrades  

• Enhance Needs Outsourcing in Schedule View. 

• A new column (Next Verification Type) was added to Schedule View which is determined based on the last eligibility / last benefit date from Open Dental. New Verification Type includes Breakdown and ReVerification

• Archive functionality in the Bulk Import. 

• Backend improvements to map carriers, and provide In Network & Out Of Network benefits.

• Bug fixed / improvements on Schedule View.

• Additional customizations added to the list of global customizations. Now if you go to 'form customizations', you will find a lot more fields that you can enable and further customize your breakdown form! 

• Be able to select the type fee schedule if out of network

• Improve the pdf to ONLY show data for fields that you have customized for your office

• On 'ScheduleView' show if the patient is the subscriber or dependent

• Now you can enter the waiting period in days as well as months

• A lot of data improvements to find and display more data than ever before! 

• Dentrix: Issue resolved where some patients were not being shown on the schedule

• OpenDental: Now you can open the VeriSmart plugin and verify a single patient that is selected 

• OpenDental: Now you can outsource patients in bulk

• OpenDental: Now you can import patients in bulk

• Plenty of bug fixes to improve the quality and quantity of data presented

1. Fix Frequency for older plans under Help --> Settings Window.

2. Ability to install VeriSmart from Verrific Settings window.

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1. Add real-time eligibility and breakdown information from insurance api to ticket portal upon ticket creation.

2. Speed up bulk create and bulk import.

3. Show notification when sending more than 2 emergency verifications.

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1. Add options to filter by ticket type to Bulk Create window.

2. Fix ReVerify service year plan so new ticket type shows as Detailed Breakdown instead of ReVerify for the year 2023

3. Show status of unresolved tickets for patients coming in next 14 days in Bulk Import window.

4. Add Not Sure to Cigna Participation dropdown in Settings window.

5. Bug fix for United Healthcare participation dropdown in Settings window.

6. Ability to set default participation for carriers that not in Settings window using Carrier Group dropdown in Edit Carrier window of Open Dental.

7. Ortho information on a new detailed breakdown (new year plan) gets updated if there is change in plan benefits. (Bug fix)

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1. Add Not Sure option as default participation in settings window.

2. Option to not import co insurance for OON verifications (applicable for FFS offices)

3. Option to archive phantom records in Bulk Import Screen.

4. Ticket Emergency is considered as an Urgent if it is resolved on the same or next business day based on our business hours M-F 9 am to 6 pm CST.

5. Install multiple Verrific installations on same computer to support multiple Tax ids and different participations between the providers.

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1. Ticket Priority determined based on appointment time.

2. One time fix to import missing frequencies.

3. Use ConnectWise for remote support.

4. Bug fixes and enhancements.

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1. Ticket status. Resolved means breakdown is completed and Closed means incomplete ticket (i.e Needs additional info). 

2. We will be asking Annual Max Remaining and Deductible Remaining instead of Annual Max Used and Deductible Used.

3. We will be asking Ortho Age for Dependent as well. Subscriber age goes to benefit window and dependent age will be included in plan note.

4. Adding pdf to freshdesk ticket when ticket is resolved.

5. Default Participation for more insurances in settings window.

6. Add Effective Date in ReVerification ticket.

7. Subscriber note is appended instead of overwritten.

8. Internal QA workfolow to improve quality of verification. 

9. Bug Fixes and Operation efficiency.

10. Priority Emergency for apt today and next day else Non-Emergency.

11. Bulk Import - Import Pdf Bug Fix.

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1. Setting Cigna DPPO or Advantage for In Network Participation

2. Use Verrific account for audit trail purposes.

3. Fix Missing Frequencies, Re Import All Benefits, Backup Database functionality for Verrific IT Support 

4. Pdf enhancements (move custom codes closer to code specific questions, add subscriber id, requested/verified participation on header)

5. Requested Participation and Verified As added to plan note.

1. Bug Fixes. 

2. Bulk Import. Import multiple closed tickets in one click. 

3. Settings Window has fix missing frequencies button that will fix all plans verified by Verrific. 

4. Amount Used / Deductible Used is added to Subscriber note and adjustment will not be made to plan.

5. Auto update without administrator rights.  

6. Add Group Number and Group Name to plan when those fields are left blank. Employer Name is added to plan note.

7. Pdf newer format with Group #, Name, Participation Details. Removed redundant information. 

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1. Bug Fixes.

2. Bulk Verification. Create multiple tickets in one click. 

3. Default Network Participation for Delta and Non-Delta in Setting Window.

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