Coming Soon!!
The Real Pre-Care Eligibility API provides dental providers real-time visibility into a patient’s eligibility, coverage, and benefit details before the patient’s visit. Through a single, centralized API, providers can access eligibility information across multiple dental payers directly within their existing practice management systems, reducing manual effort and improving the patient experience at the point of care. With real-time benefit visibility, providers can better prepare for patient visits, reduce coverage‑related surprises, and ensure a smoother experience for both staff and patients.
Key Features
- Helps users determine whether a payer (for example, United Healthcare) has a particular subscriber or dependent on record
- Provides information about organizations that may have third-party liability for coordination of benefits
- Provides pre-effective eligibility for subscribers and dependents with active eligibility
- Provides eligibility information including patient demographic information, plan-level cost shares, plan coverage details, and insurance details
- Provides Coordination of Benefits (COB) including primary and coverage details for each payer’s dental plan
- Includes provider in- and out-of-network status
NOTE
This API does not itemize services for which the subscriber or dependent is covered under the insurance plan.