Dental insurance verification, answered plainly.

Confirming, before an appointment, that a patient’s plan is active and documenting what it covers: annual maximum and remaining benefits, deductible, coverage percentages by category, frequency limits, waiting periods, missing-tooth and downgrade clauses, and pre-authorization rules. Offices do it by payer portal, phone, fax or an electronic 270/271 eligibility transaction. Read the guide to dental insurance verification.

Eligibility answers yes or no on whether the patient is covered on the date of service. Verification (a benefits breakdown) records the plan’s limits and rules so the office can estimate the patient’s share. A 270/271 often answers only the first question; dental offices still use portals and phone calls for the rest (CAQH Index 2023; Open Dental manual).

Each payer has a playbook: the provider portal first (a deterministic field map reads the portal’s own data), or an EDI 270/271 inquiry or an IVR-requested faxback where that is the payer’s channel. Whatever required blanks are still open, an AI voice agent phones the payer’s provider line during its business hours, up to two calls, and each answer must be backed by a quote from the rep.

Yes. Ardent stores your sheet’s PDF and draws the answers onto it, blank by blank, in your notation. Two practice sheets are in production today: a general worksheet and a pediatric breakdown. A new sheet is set up by measuring its blanks once. Blank general, pediatric and orthodontic sheets are free to download.

Ardent fills 99.8% of sheet fields accurately. Every printed value carries its source: a portal record and screenshot, the 271 rows, the fax lines, or the rep’s recorded words. A blank nobody stated stays blank; NC prints only for a stated exclusion. Results are informational; your office confirms coverage with the payer.

The next channel in that payer’s playbook runs only for what is still open, ending with a phone call to the payer. If a required blank is still empty afterwards, the sheet leaves it blank, the appointment is flagged "Someone has to call," and it appears in the 7:00 AM email to the front desk.

One weekday email covering tomorrow through the next business day. It lists each appointment Ardent could not verify, with the reason in plain words: a member ID missing, a plan the payer says has ended, a payer Ardent cannot check yet, a response without enough dental benefit information. On a clean day it is one line saying every appointment had a successful verification.

It runs on its own. The schedule is polled hourly and a 6:00 AM weekday run verifies visits up to two weeks out, five business days by default; failures that will clear on their own retry after 6 and 48 hours. Your team can also run or re-run a verification for any appointment on demand, or check a patient who is not on the schedule.

Early enough to fix inactive coverage or missing details, late enough that benefits used are current. Ardent’s unattended jobs reach up to two weeks ahead, five business days by default: the schedule is polled hourly and a 6:00 AM weekday run verifies visits entering the window; a successful check within 30 days of the appointment date is reused. The window is a per-practice setting, set to whatever lead time your office wants.

Dentrix, Dentrix Ascend, Dentrix Enterprise, Eaglesoft, Open Dental, Curve Dental, Denticon, Cloud 9 and OrthoTrac through the NexHealth Synchronizer, and CareStack directly. Ardent also works with Archy, Oryx and SoftDent, with the connection set up during onboarding. In use today on Eaglesoft (Randhawa Dentistry, through NexHealth) and CareStack (Montclair Pediatric Dentistry). See the integrations pages for what Ardent reads and writes on each system.

The completed sheet as a PDF in the patient’s chart documents (named insurance-eligibility-<first>-<last>.pdf). On Dentrix, Dentrix Enterprise, Eaglesoft and Open Dental, a one-line appointment note when something on file needs fixing. On CareStack, a coverage summary with an estimated copay on the appointment’s Status & Notes and Patient Memo. Ardent does not overwrite coverage-table fields.

No. Ardent removes the portal logins, hold time and worksheet typing. Your coordinator handles the exceptions Ardent flags: details to fix on file, plans Ardent cannot check yet, blanks a payer would not state. They also explain estimates to patients and manage pre-authorizations.

Ardent operates payer-specific playbooks for 71 payers, including 42 Delta Dental member companies, MetLife, Cigna, Aetna, Guardian, UnitedHealthcare Dental, United Concordia, Principal, Ameritas, GEHA, Beam, Humana, Anthem, several Blue Cross Blue Shield dental plans, FEDVIP plans and Medi-Cal Dental. A plan Ardent cannot check yet is named as such in the morning email. See the payers Ardent verifies.

A plan provision excluding coverage for replacing a tooth lost before the patient’s coverage began. Verify it before treatment-planning bridges, implants or partials. On the general worksheet the printed question is "PRIOR EXT COVERED?", which Ardent answers YES or NO only when the payer states it. More terms from the sheet, defined.

Yes, for portal automation. Credentials live only for the duration of the call that needs them and never enter a model, a log line or a response; every portal request is limited to that payer’s domain; emailed one-time codes are read from a mailbox you designate; Ardent never solves CAPTCHAs. Payers without a portal are worked by EDI, fax or phone.

Connect the PMS (NexHealth’s Synchronizer on your server or its Chrome extension for cloud PMSs, where NexHealth says to allow up to 72 business hours; for CareStack, a dedicated login you create), share payer portal credentials, choose your sheet, then Ardent switches on polling, ahead-of-visit verification, filing and the digest one at a time after a supervised first run.

Ardent operates as a HIPAA Business Associate and signs a Business Associate Agreement (BAA) with every practice. Every subprocessor that handles protected health information does so under a BAA, and AI extraction and the voice model run on a zero-retention endpoint. Data is encrypted in transit (TLS) and at rest, access is least-privilege, PHI access is audit-logged and PHI is excluded from application logs. Payer calls are recorded with a disclosure on the call. Details are in the Privacy Policy. More on the security page.

Outsourced verification runs about $6.50–$8.25 per check and $12.50 or more for a rush (Dental ClaimSupport, a vendor blog); eAssist lists $235–$840 per location per month. Done in-house, a manual check takes about 12 minutes of staff time (CAQH Index 2024), roughly $6.52 at an insurance coordinator’s $15.71–$18.26 hourly wage. Ardent costs $849 per practice per month with unlimited verifications and no rush charge; at 500 verifications a month that works out to about $1.70 per verification. The full comparison, with sources.

A benefits breakdown, also called a breakdown of benefits, benefit breakdown form or insurance verification worksheet, is the sheet a practice fills in for each insured patient before the visit. It records the plan’s annual maximum and remaining benefit, deductible, coverage percentages by category (preventive, basic, major, orthodontic), frequency and age limits, waiting periods, missing tooth and downgrade clauses, and pre-authorization rules, so the office can estimate the patient’s share. Ardent fills the practice’s own breakdown form, blank by blank, rather than replacing it with a new one. Download a blank breakdown worksheet.

The 270/271 is the HIPAA-standard electronic eligibility inquiry (270) and response (271) that a practice or its clearinghouse sends to a payer. It confirms whether coverage is active on the date of service and sometimes returns a few benefit lines, but it rarely answers a full breakdown: frequency limits, waiting periods, downgrade and missing tooth clauses usually still need the payer’s portal or a phone call (CAQH Index 2023; Open Dental manual). Ardent uses the 270/271 where it is a payer’s channel and works the portal, the fax line and the phone for the rest.

Yes. Ardent operates playbooks for 42 Delta Dental member companies, including Delta Dental of California. It signs into the Delta Dental provider portal with the practice’s credentials, reads the benefit grid field by field, keeps the portal record and screenshots as the source, and phones the provider line only for required blanks the portal leaves open, with each answer backed by a quote from the rep. How Ardent verifies Delta Dental plans.

Yes. Ardent fills whatever sheet the office already uses. A general worksheet and a pediatric breakdown are in production today; a pediatric sheet asks for age limits, which teeth a sealant covers and codes a general sheet never lists, and an orthodontic sheet asks for a lifetime maximum, a banding date and a payment schedule. A new sheet is set up by measuring its blanks once. Ardent connects to Cloud 9 and OrthoTrac through the NexHealth Synchronizer, and Montclair Pediatric Dentistry in Oakland runs it on CareStack. See the Cloud 9 and OrthoTrac pages.

Ardent is in use at dental practices in the San Francisco Bay Area: Randhawa Dentistry (Emeryville and Alameda, on Eaglesoft), Montclair Pediatric Dentistry (Oakland, on CareStack), Chestnut Square Dental (Concord), Crossroads Dental Care (Vallejo) and Pinole Hills Dental (Pinole). Ardent serves dental practices anywhere in the United States; the payer playbooks and practice management system integrations are not tied to a region.