Insurance verification for oral surgery practices on WinOMS.

We read the payer's own portal. The electronic feed only fills blanks.

An eligibility feed is a summary - a category percentage, a plan maximum, an active flag. The detail that decides an estimate lives on a screen behind a login: coverage per procedure code, the date of the last bitewings, the downgrade clause, the missing-tooth clause, the waiting period. Kaylie holds the login and reads that screen. Where we also pull the electronic feed, it is allowed to fill fields the portal left empty and nothing else.

Check it: Take five plans from your own book whose breakdowns your team argues about. Compare field by field against what your current process returns.

It learns across every practice on the network, not just yours.

What Kaylie learns is keyed to the contract - the carrier and the employer group - rather than to your office. So if another practice has already had a claim settle on the same plan, your first patient on it starts with what that taught. This matters most for the rules carriers do not state up front. A downgrade is the clearest case: a plan that pays a posterior composite at the amalgam rate rarely announces it, and an office usually finds out from the first write-off.

Check it: Name a plan whose downgrade rule cost you a write-off. Ask what the network already knows about that carrier and group before you sign anything.