"Do you take my insurance?" is one of the first things callers ask, and "we'll check and call you back" is where many of them go elsewhere. With AI receptionist insurance verification from ELVA RCM, Elva answers on the call: whether you take their plan, what it covers for this visit, and an estimated cost when one can be worked out. She keeps the conversation going while the check runs, then books the visit the way you set it up.
Elva never works out coverage herself. Every answer comes from ELVA RCM's real-time check and your own plan list, and every cost is called an estimate. Live checks are for offices that also use ELVA RCM.
A new patient calls, asks whether you take their plan, and hears that someone will look into it. By the time the front desk has logged in to the portal, the patient has booked with an office that told them yes on the phone. Returning patients have the opposite problem: they find out at checkout that their second cleaning of the year isn't covered.
Most offices verify insurance a day or two before the visit, long after the patient decided to book.
The best time to answer a coverage question is while the patient is asking it.
The question decides the booking. Answer it on the first call.
She checks your "plans we don't accept" list first, then your in-network and out-of-network plans in ELVA RCM. For each status she says your words, for example: "We're out of network with that plan, but you can still use your out-of-network benefits here, and we'll bill your insurance for you." Then she does the next step you chose: check coverage and book, book without checking, take a callback for your insurance coordinator, or transfer.
Elva takes the carrier, member ID and subscriber from a new caller, or uses what's on file for a returning patient, starts a real-time eligibility check through ELVA RCM, and keeps talking: "While I check that, what day works best?" A few seconds later she reads the result.
She says what the plan covers for this visit and, when ELVA RCM can work it out from the plan and your fees, an estimated cost, always called an estimate. If the plan won't cover another cleaning yet, she says so and offers times from the date it will. If coverage can't be confirmed, she follows your setting: book and flag it for your coordinator, or take a callback.
Asked on the call. Answered on the call.
Answered from your in-network and out-of-network list in ELVA RCM.
Your own list, such as Medicaid or DHMO plans, checked first.
What Elva says, and what she does next, for each status.
Benefits, deductible, maximum left and frequency limits, checked on the call.
Elva keeps the conversation going while the check runs.
Only when ELVA RCM can work it out from the plan and your fees. Always "an estimate".
If the next cleaning isn't covered yet, Elva offers times from the date it is.
Book and flag it for your coordinator, or take a callback. Your choice.
The result is on the call, the patient and the appointment's Triage item.
In a 20-minute demo, hear Elva check a plan and explain it, using your own payers.
Elva asks ELVA RCM, and ELVA RCM answers from its own data: your plan list, the payer's real-time eligibility response and your fee schedule. A returning patient's insurance on file comes from your practice management system (Dentrix, Dentrix Ascend, Open Dental, Eaglesoft, Curve Dental, Denticon or CareStack); a new caller's details are saved with the booking.
Checks before the visit, for every patient on the schedule, are covered by our dental insurance verification software. Insurance on the call is part of the AI dental receptionist.
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| By hand | With Elva | |
|---|---|---|
| "Do you take my plan?" | "Let me check" | Answered from your plan list |
| Plans you never take | Booked, then cancelled | Your words, then self-pay or no booking, your choice |
| Out of network | "We're not in network" | Your out-of-network wording, then booked |
| Coverage | Checked a day before the visit | Checked on the call |
| Cost | "We'll know at the visit" | An estimate, when it can be worked out |
| Second cleaning | A surprise at checkout | Times offered from the date it's covered |
| Can't confirm | Callback, often missed | Booked and flagged, or a callback, your choice |
| Record | Notes in someone's head | Result saved on the call and the appointment |
It's the question that decides whether they book.
Patients can often use their benefits with you; say it the same way every time.
And say what you offer instead, such as self-pay.
"Delta Dental" alone is many plans.
A visit booked a week too early isn't covered.
The plan's final answer comes with the claim.
Your coordinator should see it before the patient arrives.
The next person shouldn't run it again.
ELVA AI Receptionist can, for offices that use ELVA RCM. Elva checks the caller's plan against your plan list, runs a real-time eligibility check while the conversation continues, and tells the caller what the plan covers for this visit, with an estimated cost when one can be worked out, before booking.
Yes. The plan list, the real-time check and the estimate all come from ELVA RCM. Without it, Elva still takes the caller's insurance details and answers general insurance questions from your knowledge base, but she doesn't check coverage.
Usually a few seconds. Elva starts it and keeps talking ("While I check that, what day works best?"), so the caller doesn't sit in silence.
Only if you turn it on, and only when ELVA RCM can work out an estimate from their plan and your fees. Elva always calls it an estimate. Out-of-network estimates are less certain, so for those she may give the coverage (percentage, deductible) without a dollar amount.
"Delta Dental" is many payers. Elva may ask for the payer name or phone number on the back of the card. If it still can't be matched, coverage isn't confirmed, and Elva follows your setting: book and flag it, or take a callback for your coordinator.
You keep a short list on the Insurance settings page, separate from ELVA RCM, because it's your office's policy. For those plans, Elva says your words and can offer to book as a self-pay patient, not book, take a callback or transfer.
If the check shows the plan's cleanings are used up for the period, Elva tells the caller and offers times from the date it's covered again. If they'd rather come sooner, she gives the estimated cost and books it if they agree. Your own cleaning frequency rules still apply either way.
Not today. Elva explains the result on the call, and it's saved on the call and the appointment for your team.
In 20 minutes, hear Elva check a plan, explain it and book the visit, using your own payers.
1 CAQH, 2024 CAQH Index (2023 data), eligibility and benefit verification: average time savings opportunity per transaction for dental providers moving to fully electronic checks, 8 minutes. caqh.org
Dentrix, Dentrix Ascend, Open Dental, Eaglesoft, Curve Dental, Denticon and CareStack are trademarks of their respective owners.
