VOB & Pre-Auth Dashboard
Access From Menu…
The Verification of Benefits (VOB) and Pre-Authorization module can be accessed from the left menu bar for all users. Certain practices that have a legacy account that are “billing only” will have this screen set as their dashboard (homes screen) by default.
or the Home Screen.
Any user may also set this screen as their dashboard by “right clicking” on the home screen button in the bottom left corner and selecting this as their default dashboard. This allows different users to set different dashboard views when they login to better suit their individual workflow.
For those clients who have elected to utilize AireO2 billing service, your dashboard has been connected with our billing team who works from a centralized version of this dashboard to support VOB, Pre-Auth, and GAP requests from practices.
Layout & Overview
The VOB and Pre-Auth Dashboard contains four major areas:
1. Display filter allowing you to view cases by their status (top line in larger font) or by type (second in line smaller font). We recommend using ONLY ONE of the filters at a time. Using these filters in combination creates “and/or” logic. For example, if you select “Requested” and then select “VOB” it will display any cases that have been requested and/or that are VOBs.
2. Log of all requests (main area of the page) where any requests that have been created will display (see next page for further definition of each Column.
3. Search filter allowing for additional fields to search for cases (i.e. by patient, date, user, etc..)
4. Button to “Create New Request” which will pull up a screen to enter information about the patient and services requested (VOB, Pre-Auth, GAP)
NOTE: Please refer to our Billing & Compliance Guide for additional direction on the recommended workflow regarding VOB, Pre-Auth, and GAP. In summary, we recommend that you request a VOB before starting any case so our team can verify eligibility and provide you with benefits details, including whether or not a pre-authorization is even required for the service(s) requested. Once this has been completed, you may wish to make a separate request in order to have our team obtain a pre-authorization from the plan. Additional documentation will often be required (office must upload to patient documents) to successfully process these requests. A GAP request is only relevant when the provider is “out of network” and requests that the health plan process the case with the patient’s “in-network” benefits to reduce out of pocket costs for the patient. These cases are hit or miss and only honored by the health plan when there is truly a “gap” in their provider network.
Below are brief definitions for the columns which display information about each request:
Patient ID: Unique ID to safely identify patients without PHI
Created Date: Date you created this request
Patient Name: Salutation, First Name & Last Name of Patient
Insurance Name: Insurance company selected in Patient Demographics
VOB: Status of the VOB request (if requested) – see status page of this doc
Pre-Auth: Status of the Pre-Auth request (if requested) – see status page of this doc
GAP: Status of the GAP request (if requested) – see status page of this doc
Days Elapsed: Days since created date that have passed
Requested User: User at your practice/facility who generated the request
Actions: See actions page of this doc
Creating a New VOB Request
To “create a new request”, click the corresponding button in the upper right portion of the screen.
A pop-up screen will slide over prompting you to enter the necessary Information on the patient and the request. Fields with red asterisk are Required however all fields are critical in sending a request to the AireO2 Dental Billing Team.
It is important that you have accurate and complete insurance and Patient demographics added PRIOR to generating these requests. In Addition, we strongly encourage the following DOCUMENTS be uploaded to the patient chart:
- Copy of the patient’s insurance card (front and back)
- Supporting documentation (relevant to the procedures requested). Please see our Billing & Compliance Guide for further direction.
1. Begin typing the name of the patient to select the Patient. The patient’s Primary Insurance will automatically display along with the Policy Number. This information must be previously entered in the patient demographics.
2. Select the appropriate Provider and Facility (this is very important for practices with multiple providers or locations).
3. Select the type of request (VOB, Pre-Auth, or GAP)
4. Enter Procedure Codes of the planned service(s) by typing numeric code or description. Use the + button on the right to add more procedures. Start typing procedure code and those will appear. If there is a procedure code not here, your Admin may add that code in the “Code Types” settings.
5. Select a Primary Diagnosis (ICD-10) by typing in numeric code or description. If you are requesting a Pre-Auth, you have the option of indicating to our team when you would like us to have the insurance company “start” the Pre-Auth (for example some may only give us a 30 day window so you may want to set a date two weeks out if you are not delivering a case for another three weeks.
The VOB x-12 Partner will automatically default to the clearinghouse we use for claims; there is no need to address this section as our billing team will manage this.
You may choose to attach documents here which will get stored in the “VOB & Pre-Auth” folder within the Patient’s Documents.
Be sure to SAVE your request.
Save as Draft
Save & Request will save and send this request to the BIS billing team to process. It will initially be displayed in the main dashboard as a “Requested” item.
Once you have SAVED the request, you will see it display within the main area of the dashboard. The status will change as the BIS billing team begins to work on your request. If you have only requested a VOB, then you will only see a status for this column and likewise for Pre-Auth and GAP.
You will also have the ability to take certain “Actions” on a request (on the right side). Additional pages will provide further details.
Status of Your Requests
Back in the main dashboard, you can view the status of your requests which will be updated by the BIS billing team as we process them.
You can also click the status as a display filter at the top. We have included definitions of the various statuses you may see in the respective request types (VOB, Pre-Auth, GAP):
Unsubmitted: You have saved the request as a draft as this has not been received by our billing team for processing.
Requested: This is a request that has been received by the BIS billing team.
Need Additional Information: The BIS billing team needs additional information from the office to complete the request. See request icon to view details.
Completed: A VOB request that has been finished See request icon to view details.
Approved: A Pre-Auth o GAP request that has been approved by the health plan. See request icon to view details.
Denied: A Pre-Auth or GAP request that has been denied by the health plan See request icon to view details.
Authorization Not Required: A Pre-Auth or GAO request that does not require an actual authorization be filed with the health plan. See request icon to view details.
In Process: Due to the time it can take to have a final response on Pre-Auth/GAP, we will have additional status to let you know it is “in-process” with the health plan. This will expand on the status of “Requested” to let you know it is being worked on.
Window that shows log of all activity on this request; you or the BIS billing team may post COMMENTS here
Window of the patient’s main chart (demographics) if you need to reference or update without navigating away from this dashboard
Window of patient’s documents folders for reference or if you need to add a required document without navigating away from the dashboard
MOST IMPORTANT – View your original request or see the BIS billing team’s response/details
A list of previous encounters by any providers in this practice for reference
The icon of “View VOB & Pre-Auth Response” is most useful when you need the details on a VOB, Pre-Auth, or GAP response/status.
A window will display which shows your ORIGINAL request. Click the “View Response” button in order to see the RESPONSE from the BIS billing team after initiating or completing this request with insurance.
1. The BIS billing team will provide important details in this screen regarding your request.
2. A header section displays data from your original request as well as a STATUS of each of the request types. If a request type was not made, the status will simply display “unassigned”
3. A VOB section will display details such as coverage effective dates, plan types, and deductible remaining.
4. Below that, a section for each CPT code will display specific benefits for each procedure code requested AND whether or not a pre-authorization is required by the plan.
5. A Pre-Authorization/GAP section will provide details about those requests including Auth #, start and stop date and relevant notes.
6. Additional Notes will be populated regarding the requests in its entirety.
Scheduling Workbench Dashboard
The “+ New Schedule” is the first step to add a new/existing patient into this Workbench. You are not necessarily placing the patient into the calendar for an appointment unless you select “schedule date”. A pop-up box will display and prompt you to either to search for an existing patient or allow you to “ADD” a patient. To add a new patient, you must enter the minimum information in the boxes that are high-lighted red that include:
- First & Last Name
- Phone & Email (these are important for outreach related to this scheduling workbench)
Scheduling Appointment with Scheduling Dashboard
Activity Log & Demographics