You can receive and post electronic insurance payment information to the database using ERAs. You can use the Batch Insurance Payment Entry dialog box to post insurance payments manually by check or to review, edit, and post insurance payments electronically. When an ERA is received from Dentrix eServices, a copy of the EOB is saved to the Document Center in HTML format and attached to each patient and insurance plan contained in the ERA.
Note: To receive an ERA, you must first register with Dentrix eServices.
The following terms are key to understanding ERAs:
· Explanation of Benefits (EOB) - A written statement to a beneficiary from a third-party payor after a claim processes indicating which benefits and charges were or were not covered by the dental benefits plan.
· Electronic Remittance Advice (ERA) - An electronic version of a provider's Remittance Advice that allows the provider's office to post accounts receivable electronically rather than manually.
· Claim Adjustment Reason Codes - Communicate why a claim or service was paid differently than it was billed.
· Dentrix Claim - Refers to claim information already in the Dentrix database.
· EOB Claim - The part of an ERA directly related to a claim sent from Dentrix for payments or adjustments. The term refers to the new database information from payors.
· Skipped Claim - A claim that could not be processed because a necessary file was open at another computer, the claim could not be found in the database, or the claim contained adjustments and Skip Adjustments was selected.
· Reversals and Corrections - Claims paid in error are corrected by reversing the original claim and re-sending the corrected data.