ERA User's Guide

Some payers provide an electronic Explanation of Benefits (eEOB) as an Electronic Remittance Advice (ERA) for an electronic claim that you submit. Dentrix Enterprise can receive and parse ERA files from insurance payers 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. Before you purchase the ERA add-on, make sure that you meet all the prerequisites. Then, contact your customer success manager to purchase the ERA add-on.

Before you schedule training on using the ERA features, make sure that you first complete all the setup tasks for the ERA add-on (see also the ERA Checklist).

Prerequisites

You must have Dentrix Enterprise version 8.0.7 CU5 or later installed.

You must already be submitting claims using eClaims.

If you have not already done so, you must register for the ERA service.

Setup

After you have purchased the ERA add-on, call the support department 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).

The automatic receiving of ERA files also requires your eTrans (eClaims) or Data Services account to be linked to the Dentrix Data Services service in Dentrix Enterprise.

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.

Usage

Managing ERAs with Insurance Collection Manager:

Insurance Collection Manager

Opening Insurance Collection Manager

Searching for ERAs

Viewing the claims on an ERA

Possible statuses for ERA files and claims

Idle mode

Retrieving eEOBs manually

Importing ERA files manually

Viewing ERA details

Skipping claims

Matching claims

Active and saved sessions

Posting a batch of insurance payments from an ERA.