Insurance

ERAs and What They Can Do For Your Practice

ERAsIs your office processing a high volume of paper EOBs? Did you know that you can receive them electronically, improving efficiency & productivity, and virtually eliminating data entry errors? We’d like you to meet the ERA835. ERA stands for Electronic Remittance Advice, the 835 is programmer talk for the file format, just another way of saying electronic EOB.¬†ERAs are one more step on the road to a truly paperless practice. Instead of manually entering payment information, notes, and scanning the EOB into the claim, ERAs allow you to automatically import all the information electronically from the carrier, your only job is to verify it. No more losing EOBs in a stack of paperwork, spending hours on data entry, or making sure your scanner is hooked up and working properly. A couple of clicks with ERAs and you’re good to go!

Lesson 1: Before you Begin

You need to have a clearinghouse that supports ERAs. There are two dental Clearinghouses integrated with Open Dental that will automatically download the ERAs for you, ClaimConnect and EDS (Electronic Dental Service). For medical claims, Emdeon (Change Healthcare) is integrated to automatically download ERAs.

Other clearinghouses may offer ERA’s, but they may not automatically download them for you. ERA’s have to be downloaded to your computer before you can use them in Open Dental. The download is simple, but you’ll have to remember to do it each time. See ERA Troubleshooting for steps on how to manually download ERA reports.

Lesson 2: Managing ERAs

You can access your ERA’s in the Manage Module. Click the ‘ERAs’ button to see your list of unfinalized ERAs. If the ERA has one patient, you’ll just see the patient’s name and info. If the ERA has multiple patients, you’ll see the number of patients attached.

ERAs

Double-click an ERA to start processing. Open Dental will attempt to find the matching claim for you. If one isn’t found, you can search for it on your own.

Lesson 3: Receiving the ERA

Now that you’ve opened the ERA, you just have to verify its accuracy.

Double-click on a claim in the Claims Paid grid. Here you will see the write-offs, paid amounts, and any remarks.

ERAs

TECH TIP:

  • Use the ‘Detach Claim‘ and ‘Find Claim Matches for Detached‘ buttons to correct any mismatches.
  • Click ‘EOB Claim Details’ to see any notes and procedure details as needed.
  • Want to view the ERA for a patient? Open the claim, and click the ‘View ERA’ button.

Verify the information sent by the insurance carrier and make corrections as needed. Click OK when everything is ready and complete.

Lesson 4: Finalizing the Payment

Once all claims on the ERA are received, click ‘Finalize Payment’. The payment amount, carrier name, and EFT # will automatically populate. Manually enter the payment type and any relevant notes.

TECH TIP: If you have detached any claims from an ERA, finalize the payment from the Manage Module – Batch area, or from the patient’s account instead.

ERAs

Click OK to view claims attached to the payment, then click OK to finish finalizing the payment.

Are ERAs a good fit for your practice?

High-volume practices have the most to gain from using ERAs. If you’re struggling to keep up with the flow of insurance payments and associated paperwork, contact your clearinghouse to see if ERAs are available for you, then follow the steps on our ERAs page. As always, if you need help troubleshooting anything, just reach out – we’re here for you!