Get the Full Insurance Breakdown, Not Just "Active" Status
Stop relying on simple "Green Checks" that only tell you a policy exists. Elva verifies the entire contract. It reads the fine print for hidden frequency limits, waiting periods, and replacement clauses at 72, 48, and 24 hours before the appointment, ensuring your treatment plan estimates are accurate to the penny.
72/48/24h Auto-Verification
Checks benefits three times before the visit to catch last-minute coverage changes or lost eligibility.
True PMS Write-Back
Writes plan details, fee schedules, and subscriber data directly into your chart. No manual entry needed.
Family Max Tracking
Monitors shared annual maximums to prevent one family member from accidentally draining the whole fund.
Detailed Code Breakdown
Checks eligibility for specific high-risk codes like Nightguards and Implants, not just general categories.
Don't Just Read Data. Write It.
The Old Way (Portal Surfing): Staff log into 5 different portals, download PDF summaries, and manually type "100/80/50" into the patient’s file. They miss the nuanced clauses (like "Missing Tooth") because they don't have time to read the 20-page document. The Elva Way (True Write-Back): Elva doesn't just read the data; it writes it. It updates the Fee Schedule, Coverage Table, and Payment Logic directly inside your PMS (Dentrix/Open Dental/Eaglesoft). It corrects patient demographics, fixes typos, and sets up the "Subscriber ID" perfectly so your team never has to touch the insurance setup.
Don't Run a Report. Just ask in the Chat
Your clinical team can use Elva Chat to get instant answers about coverage without leaving the operatory or bugging the front desk. Dr. Smith: "Is this patient eligible for a Full Mouth Debridement (D4355)?" @Elva: "No. This patient had a Comprehensive Exam (D0150) on Jan 10th. D4355 is typically bundled if an exam has already been performed. I recommend proceeding with Prophylaxis or SRP if clinically indicated."
"Active" Status ≠ Payable Claim
A green checkmark only means the policy exists. It doesn't tell you about the Missing Tooth Clause or the 12 Month Waiting Period that will deny your $3,000 bridge. Elva doesn't just Verify; it gets the full Breakdown.
The Engine That Powers Your Front Desk
Automated workflows that turn raw data into actionable financial clarity, giving your team the answers they need without the manual research.
72/48/24h Verification Loop
Visual Data Capture (OCR)
Family Maximum Tracking
The "Morning Huddle" Insight
The "Fine Print" Analysis Engine
Eligibility is more than just "Active" or "Inactive." Elva analyzes the complex logic behind the claim, scanning for specific clauses like "Missing Tooth," "Waiting Periods," "Age Limits," and "Downgrades", to catch the hidden exclusions that cause 80% of denials.
The "Missing Tooth" Clause
This is the #1 cause of high-value write-offs.
Elva's Solution: Elva cross-references the Extraction Date (from history or patient intake) against the Policy Effective Date.
It alerts you immediately: "Warning: Tooth #19 is excluded from replacement.
Patient is 100% responsible."
Rolling vs. Calendar Year Limits
Their plan allows "2 per year," but follows a "Rolling 12-Month" rule, meaning they aren't eligible until March because their last visit was late last year.
Elva's Solution: Elva queries the exact "Date of Last Service" for D1110/D4910.
It calculates the precise eligibility date based on the specific plan type (Rolling vs.
Calendar) and flags the appointment if it’s too early.
The "5-Year" Replacement Rule
The claim is denied because the old crown was placed 4 years and 11 months ago, missing the 5-year replacement window by just a few weeks.
Elva's Solution: Elva scans the patient's entire clinical history and claims data for the Original Placement Date of the prosthesis.
It warns you if the replacement window hasn't opened yet.
The "LEAT" Clause (Downgrades)
The insurance downgrades it to the Amalgam (silver) rate (LEAT clause), and the patient gets a surprise bill for the difference.
Elva's Solution: Elva identifies the "Least Expensive Alternative Treatment" clause during verification.
It automatically adjusts the patient’s estimated portion in the treatment plan to reflect the downgrade, so you collect the real amount upfront.
Class III Waiting Periods
You start treatment, only to find their new policy has a 12-month waiting period for major work.
Elva's Solution: Elva categorizes coverage by class (Preventive vs.
Basic vs.
Major) and checks the Policy Start Date against the Waiting Period duration.
It flags Major procedures as "0% Coverage" until the specific date is reached.
Sealant & Fluoride Limits
The claim is denied because their specific plan only covers sealants up to age 14.
Elva's Solution: Elva reads the Age Limitation field for every preventive code.
It compares it to the patient’s DOB and triggers a "Financial Friction" alert: "Patient is over age limit for Sealants.
Bill full fee to patient."
Eliminate the "Surprise Bill"
See the hidden exclusions and frequency limits that standard eligibility checks miss. Eliminate surprises and protect your production.
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