Verifying Insurance

When you’re verifying insurances, you want to have some key information including first and last name, social security, birth date, and their member ID number. Having this information helps you find the correct patient efficiently and narrows down the chances of confusing them with another patient. We use a software called CHAMPS, which is our main tool for this process. Below is a visual guide on how to log into CHAMPS and verify a patient’s information:

Steps:

1. 1

   Log in.

   

2. 2

   Select CHAMPS and acknowledge.

   

3. 3

   Select “All Access,” then choose “Member” at the top of the screen and “Eligibility Inquiry.”

   

4. 4

   Input the information needed to verify and hit the submit button in the top left corner.

   

5. 5

   Select “Print Member Summary.”

   

6. 6

   This will show what type of insurance (if any) the patient has. For example, this patient has Healthy Kids, abbreviated as HK. Go to the Delta Dental portal to confirm they are active. Once confirmed, save a screenshot and import it into the patient’s SmartDoc.

   

Additional Information

We use other sites to verify insurance as well, such as Dentaquest, Dental Office Toolkit, United Healthcare, Blue Cross Complete, and Molina. However, CHAMPS is a good starting point to determine the next step in the verification process.

If you see the blue sentence (shown below) while checking CHAMPS, it indicates that the patient has straight Medicaid. Click “Print Member Summary” and save a screenshot to SmartDoc as mentioned above.

Insurance Portals and Prefixes

Each insurance has a different prefix and is verified in different portals. Once you determine the type of insurance the patient has from the CHAMPS website, use the chart below for the next steps.