Enrolling locations in the ERA service for the first time

The first step in setting up your organization to receive ERAs is to enroll locations in the ERA service. The ERA service is provided by DentalXChange, and they have partnered with Zentist, who can help you with your enrollment needs.

Notes:

• Payers deliver ERAs by Federal Tax Identification Number (TIN), so an ERA may contain data for claims that were submitted from multiple locations using the same TIN.

• Before you attempt to enroll locations in the ERA service, an active eTrans account must be associated with each service location. When you sign up for an eTrans account, you must specify a TIN. You can also specify a type-2 billing NPI (for a location that is set up as a billing entity).

• If your organization has multiple locations that use the same TIN, you should enroll all those service locations (eTrans accounts) at the same time using separate type-2 billing NPIs for each location.

• To complete the enrollment process with payers, you must already be submitting claims electronically with an eTrans account.

• Enrolling locations and designating the routing method for ERAs requires the "Manage ERA Enrollment" security right.

To enroll locations in the ERA service

1. On the Settings menu, under Production, click (or tap) ERA Options.

   The ERA Options page opens.

   

2. Click (or tap) Enroll for ERAs.

3. If the Mandatory Payment Tags for ERAs message appears, one of more of the insurance payment types ("Insurance Payment - Check," "Insurance Payment - Electronic," and "Insurance Payment - Credit Card") have a mandatory tagging restriction, but the mandatory tag to use for the automatic posting of ERA payments has not been selected yet. Click (or tap) the Ledger Options link in the message (or select Ledger Options on the Settings menu), customize the transaction types accordingly, return to the ERA Options page, click (or tap) Enroll for ERAs, and then proceed to the next step.

   

4. On the Enrolled Locations tab, select the checkbox of each location that you want to enroll, or select the All locations checkbox.

   

   Note: If a location does not qualify for ERA enrollment, a yellow warning icon appears next to that location's name. For a location to qualify for ERA enrollment, an active eTrans account must be associated with that location.

5. On the ERA Routing tab, specify the routing method that will be used for ERAs.

   

   Note: Dentrix Ascend attempts to determine the correct location for each claim on an ERA by using the following hierarchy:

   1. TIN + Claim control number

   2. (if #1 fails) TIN + Date of service, patient first name, patient last name, member ID, and billed amount (all five must be matched).

   3. (if #2 fails) TIN + Type-2 billing NPI.

   Depending on the routing method, Dentrix Ascend may split an ERA (835) after receiving it from the payer and then route those portions of the ERA to their respective locations. Select one of the following options:

   • Route ERAs per location - Each ERA will be routed to the originating claim's location.

     

   • Route ERAs to Central Billing Office - Each ERA will be routed to the specified central billing office regardless of the origination claim's location. With this option selected, select the correct location from the Central Billing Office list.

     

   • Route ERAs to Regional Billing Offices - Each ERA will be routed to the specified regional billing office for the originating claim's location. However, if an originating claim's location is not assigned to a region, the corresponding ERA will be routed to that location.

     

     With this option selected, do the following as needed:

     • To create a regional billing group, do the following:

       1. Click (or tap) New Regional Billing Group.

          A new group with an editable text box is inserted at the top of the list.

          

       2. In the box, enter a name for the billing group.

       3. Click (or tap) the Done (check mark) button.

     • To assign locations to a regional billing group, do the following:

       1. Expand Unassigned locations.

       2. Select the checkbox of the location to be designated as the group's billing office and the checkbox of each location to be assigned to the billing group.

          

       3. On the Move Selected To menu, click (or tap) the name of the correct billing group.

          The Select Regional Billing Office(s) dialog box appears.

          

       4. From the list of locations that you are assigning to the billing group, select the correct billing office for the group.

       5. Click (or tap) Select.

6. Click (or tap) Save & Proceed with Enrollment.

   The Enroll for ERAs dialog box appears.

   

7. Click Enroll.

   Note: The enrollment process may take up to five minutes to complete. During this time, no one can make changes to the enrollment and routing options.

   

8. When the enrollment process is complete, you can enroll for ERAs with participating payers.