Some payers provide an electronic Explanation of Benefits (EOB) as an Electronic Remittance Advice (ERA) for an electronic claim that you submit. Dentrix Enterprise can receive ERAs from insurance payers through a clearinghouse automatically. This saves time and reduces mistakes compared to the manual downloading and importing of ERA files. However, you can manually import ERAs (in the 835 X12 4010 standard format) as needed. Also, the Insurance Collection Manager provides a central location where insurance billing coordinators can manage ERAs and post batches of insurance payments to multiple patients' accounts.
Notes:
The ERA features are available as an add-on that you can purchase by contacting your Strategic Account Executive.
Before you schedule training on using the ERA features, make sure that you first complete all the setup tasks.
Important:
Not all payers provide ERAs. To verify if a payer provides ERAs, you can use the payer search tool on the Dentrix Enterprise website: www.dentrixenterprise.com/products/addons/eclaims/payor-search-tool.
Only dental ERAs are supported. Medical ERAs are not supported.
Dentrix Enterprise version 11.0.2.1147 or later must be installed.
You must already be submitting claims using eClaims. For the automatic receiving of ERA files, you use the same eTrans (eClaims) or Data Services accounts that you use for eClaims.
After you have purchased the ERA add-on, call Dentrix Enterprise Customer Support at 800.459.8067, option 2, to have a representative turn on the global setting that makes the ERA features available.
The automatic receiving of ERA files requires the Dentrix Enterprise DataService Client service to be installed and running. You can install this service when you are installing or upgrading Dentrix Enterprise. Alternatively, you can install the service after installing or upgrading Dentrix Enterprise (the executable is located in the following folder on the server by default: C:\Program Files (x86)\DXONE\3rd Party Installs\DataService).
Set up additional ERA options as needed. You can specify the default provider for charge adjustments, if credit adjustments will be applied automatically, the default adjustment types, and if ERAs will be copied to Document Center.
Assign users the applicable security rights:
Insurance Collection Manager, Open - Allows a user to open the Insurance Collection Manager window.
Insurance Collection Manager, Manual Matching - Allows a user to work with claims that have been received with an error. In the Insurance Collection Manager window, the user can select the Claim Not Found option to search for unmatched claims and open any ERA files with an Error Occurred or Requires User Action status.
Ins Payments, Enter - Allows a user to open the Batch Insurance Payment Entry dialog box to start a batch entry session.
Managing ERAs with Insurance Collection Manager:
Opening Insurance Collection Manager