Is your office swamped with processing paper EOBs? Did you know that you can receive them electronically, saving time and reducing data entry errors? Say hello to the ERA 835 – Electronic Remittance Advice in 835 file format – also known as electronic EOB.
By using ERAs, you can move one step closer to a truly paperless practice. Instead of manually entering payment information and notes and scanning the EOB into the claim, ERAs allow you to import all the information electronically from the carrier. Enjoy the convenience of verifying the data rather than hunting for lost EOBs or struggling with time-consuming data entry and scanning. With ERAs, you can choose to automatically process electronic EOBs – even when manually processing, all it takes is a couple of clicks!
Watch our ERA 835 webinar here
Before you Begin
You must contact your clearinghouse and enroll with participating insurance carriers to begin receiving ERAs.
Automatic downloads of ERAs to Open Dental are supported by the following clearinghouses: DentalXChange ClaimConnect, Electronic Dental Services, Denti-Cal, and Change Healthcare Medical.
Other clearinghouses may offer ERAs, but they are not automatically downloaded to Open Dental. Contact your clearinghouse to see if they offer ERAs. ERAs can be manually downloaded for processing in Open Dental. See ERA Troubleshooting for steps on how to manually download ERA reports.
ERA Preferences
Set various options for ERAs in Preferences, including how ERAs are processed.
ERAs can be processed automatically or manually depending on what ERA Automation is set to in Preferences or at the Carrier level. There are three options:
- Review All: ERAs must be processed automatically.
- Semi-automatic: ERAs can be processed using the single-click Auto Process button. This receives the associated claims and finalizes payment.
- Fully-automatic: ERAs are automatically processed when imported, receiving claims, and finalizing payment for associated claims.
Managing ERAs
ERAs can be accessed and processed from the Manage Module. Click the ERA button to open the Electronic EOBs window to see a list of outstanding EOBs. Change the filter options to also include Finalized EOBs.
If the ERA includes multiple patients, the total number of patients is listed in the Patient Name field. If there is only one patient, the patient’s name is listed.
If Fully-automatic or Semi-automatic ERA Automation is enabled, click Auto Processed Report to view the ERAs Automatically Processed Report with information on any ERAs where automatic processing was attempted, whether successful or not.
If ERA Automation is set to Review All or Semi-automatic (or Automatic Processing was attempted, but failed), double-click an ERA to process.
Receiving the ERA
If using Semi-automatic ERA Automation, review claim information and click Auto Process to mark claims (or preauthorizations) as received and finalize claim payment.
If using Review All ERA Automation or needing to manually process an ERA, double-click a claim in the Claims Paid grid to open the Verify and Enter Payment window.
TECH TIP: If a matching claim is not found when double-clicking a claim from the ERA, the ERA 835 Claim Select window will open. Search for the correct claim to match it with the ERA and process it.
Verify the information sent by the insurance carrier and make corrections as needed. Click Save to update the payment information and mark the claim as received.
Repeat these steps for any additional claims on the ERA. See ERA Workflow for detailed steps.
Finalizing the Payment
Once all claims on the ERA are received, click Finalize Payment in the ERA window. The payment amount, Carrier name, and Check # (populates EFT #) automatically populate in the Edit Insurance Payment window. Manually enter the Payment Type and add 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.
Click Save to view claims attached to the payment, then click Save on the Insurance Payment (EOB) window 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 ERA Workflow page. As always, if you need help troubleshooting anything, just reach out – we’re here for you!
Information in this post reflects features available in Open Dental Version 23.2. For the most up-to-date information, please visit our manual.