Request benefits in family module

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beacondental
Posts: 87
Joined: Wed Mar 15, 2023 8:43 am

Request benefits in family module

Post by beacondental » Tue May 09, 2023 7:24 pm

Within family module, open dental has "Request benefits" - is there a way to get an API for request benefits feature and retrieve results of the 271 normal response from Dentalxchange. This is to see if it's active coverage or not (and maybe benefit information) under 271 normal response.

As of now, this is what I see. https://www.opendental.com/site/apifamilymodules.html and https://www.opendental.com/site/apiinsverifies.html
And in here, there is no elig dates or benefits dates (there is no get function, only put).
And no request benefits feature.

justine
Posts: 168
Joined: Tue Dec 28, 2021 7:59 am

Re: Request benefits in family module

Post by justine » Wed May 10, 2023 11:00 am

beacondental wrote:
Tue May 09, 2023 7:24 pm
Within family module, open dental has "Request benefits" - is there a way to get an API for request benefits feature and retrieve results of the 271 normal response from Dentalxchange. This is to see if it's active coverage or not (and maybe benefit information) under 271 normal response.

As of now, this is what I see. https://www.opendental.com/site/apifamilymodules.html and https://www.opendental.com/site/apiinsverifies.html
And in here, there is no elig dates or benefits dates (there is no get function, only put).
And no request benefits feature.
Hello beacondental,

Are you referring to information found within the form seen here?
https://www.opendental.com/manual/ebenefits.html

Also, there is a Benefits GET, which you may find helpful.

beacondental
Posts: 87
Joined: Wed Mar 15, 2023 8:43 am

Re: Request benefits in family module

Post by beacondental » Wed May 10, 2023 11:35 am

Yes, we are talking about eBenefits under "Request benefits." Is there a way to do an API call and request results from the 271 response.
As well as, is there a way to GET and POST for eligibility date verified and benefits date verified.

justine
Posts: 168
Joined: Tue Dec 28, 2021 7:59 am

Re: Request benefits in family module

Post by justine » Wed May 10, 2023 12:09 pm

beacondental wrote:
Wed May 10, 2023 11:35 am
Yes, we are talking about eBenefits under "Request benefits." Is there a way to do an API call and request results from the 271 response.
Hello beacondental,

You can get the results from the 271 response in the etransmessagetext table.

While it is not possible to make an electronic benefits request via the API, it is possible to view previous electronic benefit requests using PUT queries/ShortQuery. This information is stored in the etrans and etransmessagetext tables.

We can add GET etrans and GET etransmessagetext to our development list, if you'd like.
beacondental wrote:
Wed May 10, 2023 11:35 am
As well as, is there a way to GET and POST for eligibility date verified and benefits date verified.
We will add GET insverifies to our development list.

beacondental
Posts: 87
Joined: Wed Mar 15, 2023 8:43 am

Re: Request benefits in family module

Post by beacondental » Wed May 10, 2023 12:18 pm

Please do add GET etrans, GET etransmessagetext, and GET insverifies to your development list.

justine
Posts: 168
Joined: Tue Dec 28, 2021 7:59 am

Re: Request benefits in family module

Post by justine » Wed May 10, 2023 1:03 pm

beacondental wrote:
Wed May 10, 2023 12:18 pm
Please do add GET etrans, GET etransmessagetext, and GET insverifies to your development list.
Great! We have added GET insverifies, GET etrans and GET etransmessagetext to our development list.

New requests are completed in the order in which they are received.
There are requests ahead of you. Completion is estimated at 6 weeks.
We will update this thread when new methods are complete with their version number and documentation.

Thank you!

beacondental
Posts: 87
Joined: Wed Mar 15, 2023 8:43 am

Re: Request benefits in family module

Post by beacondental » Thu May 11, 2023 11:26 am

I guess the question outstanding is the following:
Is there a way for the api to ping "request benefits" to see if a plan is active and not get results that a staff member clicked "Now"
When you put Getinsverity, then you are just getting the info a staff member manually modified by clicking now or you are getting the results from scheduled processes. I would like to ping directly to request benefits without staff or scheduled processes to get information on active coverage or not. And then, to get the PUT function to change the dates of eligibility and benefits. Is that better explanation?

justine
Posts: 168
Joined: Tue Dec 28, 2021 7:59 am

Re: Request benefits in family module

Post by justine » Thu May 11, 2023 1:05 pm

beacondental wrote:
Thu May 11, 2023 11:26 am
I guess the question outstanding is the following:
Is there a way for the api to ping "request benefits" to see if a plan is active and not get results that a staff member clicked "Now"
When you put Getinsverity, then you are just getting the info a staff member manually modified by clicking now or you are getting the results from scheduled processes. I would like to ping directly to request benefits without staff or scheduled processes to get information on active coverage or not. And then, to get the PUT function to change the dates of eligibility and benefits. Is that better explanation?
No. You cannot ping "request benefits" via the API. Do you still want GET etrans and GET etransmessagetext?

beacondental
Posts: 87
Joined: Wed Mar 15, 2023 8:43 am

Re: Request benefits in family module

Post by beacondental » Thu May 11, 2023 1:54 pm

Yes, please do add GET etrans, GET etransmessagetext, and GET insverifies to your development list.

beacondental
Posts: 87
Joined: Wed Mar 15, 2023 8:43 am

Re: Request benefits in family module

Post by beacondental » Tue May 16, 2023 7:49 am

As an additional request on API benefits tab, we would like to get the GET, POST, DELETE for Adjustments to Insurance benefits.
https://opendental.com/manual/adjinsbenefits.html

SLeon
Posts: 476
Joined: Mon Mar 01, 2021 10:00 am

Re: Request benefits in family module

Post by SLeon » Tue May 16, 2023 2:59 pm

You probably want to use our ClaimProcs PUT InsAdjust method.

beacondental
Posts: 87
Joined: Wed Mar 15, 2023 8:43 am

Re: Request benefits in family module

Post by beacondental » Tue May 16, 2023 6:29 pm

In this method "ClaimProcs PUT InsAdjust", it does not allow DELETE and GET fuction.

SLeon
Posts: 476
Joined: Mon Mar 01, 2021 10:00 am

Re: Request benefits in family module

Post by SLeon » Wed May 17, 2023 8:57 am

ClaimProcs GET is an existing method. You can use the PatNum parameter to filter your results by a single patient.

ClaimProcs PUT InsAdjust will create, modify, or delete insurance adjustment claimprocs depending on the situation. From our documentation, emphasis added:
This adds or changes a claimproc that is acting as an insurance adjustment. PatPlanNum is required. You can obtain the PatPlanNum from FamilyModules GET Insurance. "date" is optional and defaults to today. It should be a date within the benefit year that you are interested in. Any adjustment that is created will also use that date. Either insUsed or deductibleUsed is Required. Pass in the total insurance and/or deductible used. The logic will take into consideration existing paid claims. For example, if payments of $200 are already entered into Open Dental, and you pass in insUsed of $300, then it will result in a $100 adjustment so that it will properly show the $300. If the insUsed passed in exactly equals payments already in Open Dental, then any existing adjustment will be deleted. The calculations do not distinguish family or lifetime benefits.

justine
Posts: 168
Joined: Tue Dec 28, 2021 7:59 am

Re: Request benefits in family module

Post by justine » Wed Oct 18, 2023 9:48 am

beacondental wrote:
Wed May 10, 2023 12:18 pm
Please do add GET etrans, GET etransmessagetext, and GET insverifies to your development list.
Good morning beacondental,

Etranss GET is complete and is available in version 23.2.7.
EtransMessageText GET is complete and is available in version 23.2.11.
Insverifies GET is complete and is available in version 23.2.23.

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