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. Also, you can manually import ERAs (in the 835 X12 4010 standard format) as needed.
Notes:
The EOB importing features are available as an add-on that you can purchase. Before you purchase the EOB importing add-on, make sure that you meet all the prerequisites. Then, contact your customer success manager to purchase the EOB importing add-on.
Before you schedule training on using the EOB importing features, make sure that you first complete all the setup tasks for the EOB importing add-on.
You must have Dentrix Enterprise version 8.0.7 CU5 or later installed.
You must already be submitting claims using eClaims (also known as eTrans). eClaims (also known as eTrans) is the electronic claims service offered by Henry Schein One. To get started with eClaims, do the following:
Register for, set up, and submit electronic claims through eClaims. To purchase eClaims, contact your customer success manager.
Register for and set up the eCentral Insurance Manager.
Note: An eCentral Insurance Manager account is available at no extra cost when you register for an eClaims/eTrans account. The eCentral account remains active as long as your eTrans/eClaims account is active.
To retrieve eEOBs, you must register for the eEOB service through eClaims and enroll for eEOBs with payers. eClaims supports dental eEOBs. eClaims does not support medical eEOBs. To get started with eEOBs, do the following:
Verify if your payers provide eEOBs. Not all payers provide eEOBs through eClaims. To verify if a payer provides eEOBs, you can use the payer search tool on the Dentrix Enterprise website: www.dentrixenterprise.com/products/addons/eclaims/payor-search-tool.
Register for eEOBs. Register for the eEOB service through eClaims:
Contact your customer success manager, or visit www.dentrixenterprise.com/products/addons/eeob, and then click Get Started. Complete the registration form. Your customer success manager will follow up with the next steps.
Submit an electronic claim through eClaims. (This allows Henry Schein One to gather the information about your office that is required to set up an eEOB account.)
You will receive a "Welcome to eEOB" email message with your user name and password, which you can use to log in to the Dental Connect (co-branded) site. This welcome email message will be sent within 24-48 hours of the claim submission.
Enroll for eEOBs with payers. Log in to the Dental Connect site using the credentials from the welcome email message (see step 2b), and select the payers that you want to receive eEOBs from.
Each payer requires that you complete some sort of enrollment process. The Dental Connect website contains all the necessary information about enrolling for eEOBs with a payer, and you can see your enrollment status for any payer.
Note: If you have already enrolled with payers from the aforementioned Dental Connect website, because you set up an account on that website either directly or through a third party, Henry Schein One can provide you with a form that you can fill in so that your current EOB registrations can be transferred to Henry Schein One and transmitted through eClaims.
Contact your customer success manager to purchase the EOB importing add-on
After you have purchased the EOB importing add-on, call the support department at 800.459.8067, option 2, to have a representative turn on the global setting that makes the EOB importing 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.
The automatic receiving of ERA files requires your eTrans (eClaims) or Data Services account to be linked to the Dentrix Data Services service in Dentrix Enterprise.
For the EOB importing add-on, you can specify the default provider for charge adjustments, if credit adjustments will be applied automatically, the default adjustment types, and if eEOBs will be copied to the 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.