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API

Dental Benefits Advisor

Dental Benefits Advisor is the cutting-edge alternative to traditional Eligibility & Benefit Inquiry & Response, enabling dental providers to confidently deliver the most accurate payment plan to the patients based on their eligibility.

The inability to accurately and confidently estimate insurance reimbursements and patient responsibility poses a significant financial impact to dental providers. Dental Benefits Advisor will not only help reduce the amount of time spent on the phone with a payer or on their website to complete a full verification. It will also estimate by procedure code and treatment plan what the provider should expect to be reimbursed and what to collect from the patient at the time of service. This means less accounts receivables and potential write-offs, as well as happier patients and office staff.

Accurate

Estimates insurance expect based on historical remittance and adjudication behavior by payer and plan.

Dynamic

Intelligent real-time solution accesses hundreds of primary sources to quickly and accurately respond with the answers providers need.

Efficient

Replaces the need to contact payers or visit their website, helping reduce overhead costs.

Developer Resources

Dental Benefits Advisor API

Search Patient Eligibility and Coverage information in Details, and provides a treatment focused, procedure specific response, as opposed to a full plan breakdown

  • Customer Support Online: https://client-support.changehealthcare.com Phone: 866-820-3660
  • Technical Assistance Email: dentalproductservices@changehealthcare.com

All calls to Change Healthcare APIs are encrypted over HTTPS OAuth2 Authorization using TLS version 1.2 or higher. Access to Change Healthcare APIs is controlled via OAuth2 using the client credentials grant. This is secure authorization workflow that allows consumers to obtain a short-lived (one hour) access token that must be transmitted with subsequent API requests

API Documentation
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Frequently Asked Questions

Q: How do I access the Production APIs?

A: For the Change Healthcare Benefit Estimation API, the endpoint is: https://apis.changehealthcare.com/dentalnetwork/eligibility/v1/BenefitEstimation Eligibility also offers a Healthcheck API, with which you can check the operating status of the cloud-based API engine: https://apis.changehealthcare.com/dentalnetwork/eligibility/v1/healthcheck

Q: Does Dental Benefits Advisor replace Real-Time Eligibility?

A: No. These are two separate API calls and should be adapted to the practice workflow accordingly

Q: Does the enhanced eligibility response provide any specific detail if or when benefits cannot be estimated?

A: Yes. There are several micro-services designed to determine if any plan limitations or exclusions apply. When a procedure code is subject to a limitation, a message will be returned to indicate the limitation applied.

Q: As a dental provider, do I have to be enrolled in ERA?

A: No. However, it is recommended that each provider be enrolled to optimize the solution

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