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Onederful Partners with Principal Insurance to Automate Insurance Verifications
Let me describe the future of Eligibility & Benefits (E&B) verifications. Before a patient walks into a dental office, their Eligibility & Benefits are automatically checked with the Insurance Carrier, and that information is populated directly into the Provider’s software system.
The result is that there are: No surprise bills for the Patients, Providers can collect faster and save time with manual phone calls, and Insurance Carriers save millions on call center costs.
Sounds like an impossible reality right?
Today we announce the first step towards this reality. Onederful has partnered with Principal Insurance to enable 100% E&B information through an API to eliminate phone calls.
Onederful then standardized and transformed Principal’s E&B data to enable our network of Software Clients to easily connect to it.
The Onederful network of top Practice Management Software Companies, Dental Services Organizations (DSOs), Outsourced Billers, Dental Offices and Insurance Experts provided feedback that they could receive close to 100% of E&B information when verifying patients, thereby eliminating a 30+ minute phone call to the carrier. Data such as full patient history, procedure code limitations, downgrades, and missing tooth clauses were all available through the API.
Principal Insurance is the first of many carriers we are partnering with to automate insurance verifications. We are building a new ecosystem to transform the dental industry. If you are an Insurance Carrier interested in partnering with Onederful to eliminate phone calls, please reach out to firstname.lastname@example.org.
Our team is happy to introduce v2 eligibility and benefits API to the dental industry. After spending countless hours listening to client feedback, talking to insurance companies, and working with clinical and engineering teams, we've taken all our learnings and used them to improve our eligibility and benefits API.
We've recently updated our API developer documentation to provide more transparency and description to the underlying schema as well as provide enums used.
The main challenge with working with insurance data is that each insurance has their own language and way of structuring data, meaning there is no normalized structure across all the insurances. This causes issues at the integration level as that requires mapping and translation at a per insurance company level.
Internally, over the last couple years, Onederful has been codifying and essentially structuring data on a per insurance level to limit the scope and variability across insurance companies. Onederful's v2 eligibility and benefits API is meant to provide a universal schema to normalize data across insurance carriers.
As this has never been done in the industry before, there is still room for improvement as there are still free text sections that can be codified and placed into enums. However, with the help from you as client feedback, we can constantly improve our API and together work towards codifying across all insurances in the dental space.
If you come across any free text sections that you believe should be codified into an enum, please reach out to us at email@example.com. We greatly appreciate your feedback!