A family dentistry practice running Open Dental across multiple locations was verifying insurance eligibility by hand for every scheduled and walk-in appointment. We built an integration with the Stedi Open API that automates eligibility checks end to end, replacing manual lookup and copy paste work with real-time and scheduled verification.
Talk to UsA multi-location family dentistry practice offering general, orthodontic, and cosmetic care
Open Dental to Stedi eligibility integration: secure portal, real-time checks, and automated data mapping
Open Dental EMR, Stedi Open API, X12 EDI, JSON
Delivered and in production use
Automating eligibility verification through Stedi removed the manual copy and paste work between payer sites and Open Dental, cutting both staff time and data entry errors.
saved per patient eligibility verification by eliminating manual copy paste work
reduction in administrative burden through automated eligibility verification
reduction in human data entry and eligibility verification errors
Every scheduled or walk-in appointment required front-desk staff to touch three separate systems by hand: the payer's website, a manual validation step, and Open Dental itself. Staff time scaled directly with appointment volume, and the process opened the door to billing inaccuracies.
Staff entered patient details into third-party payer websites, validated the results, then copied verified insurance information back into Open Dental by hand for every appointment.
Payers returned eligibility data in X12 EDI format with a unique structure per payer, making standardized handling difficult.
Not every payer supported real-time eligibility verification, so the integration had to handle both instant and delayed response paths.
Verified data had to map cleanly into Open Dental's own structure for conditions, insurance, and procedures, without pulling staff out of their normal workflow to reconcile it.
The integration connects Open Dental's EMR data directly to Stedi's clearinghouse network for real-time and scheduled eligibility checks.
A secure web portal gives Open Dental users direct access to the data they need in one place, pulling insurance and eligibility details from Stedi without requiring staff to leave their normal workflow.
Requests go out in JSON or X12 EDI format through the Stedi Open API to the payer and return instant benefit data, including coverage dates, copays, deductibles, and out-of-pocket maximums.
Staff can check eligibility on demand or let the system run checks automatically ahead of the appointment date, so coverage is confirmed before the patient walks in.
Custom data-mapping logic translates Stedi's payer responses into Open Dental's own format for conditions, insurance, and procedures. Every eligibility and benefits record is stored in a HIPAA-compliant database for auditing and compliance.
Running Open Dental or another EMR and still verifying insurance eligibility by hand? Talk to us about what an automated eligibility integration looks like for your practice.
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