To properly manage ERAs, you'll want to first configure the payer settings and the AutoPost settings.
To configure the AutoPost settings
1. From the AutoPost tab, click AutoPost Settings in the top right corner to display the AutoPost Settings dialog box.
2. On each of the three main tabs, configure the AutoPost Settings:
Claim Defaults tab
a. Select whether you want Secondary Remittance, Zero Payment, Pre-Auth, and Unmatched Procedure information to appear in a pop-up window, in the Daily Detail Report, in both, or in neither.
b. Under Secondary Coverage Exists, select the actions you want taken if Secondary Coverage Exists: notification by Popup, inclusion in the Daily Detail Report, Post Primary Adjustments, Create Secondary On Primary Post.
c. Under Note Formatting Style, select the formatting style you want to use when posting ERAs to Open Dental: by procedure, by procedure category, by adjustment, or by default.
d. To include flagged procedure conflicts in the ERA notes (such as for duplicate procedures), select Include Procedure Conflicts.
e. To include notes about financial transactions in the ERA notes, select Transaction Level Notes.
Denial Codes tab
a. To configure notifications for further actions needed for certain codes when they are denied by a payer, under Denial Codes, first select the Group Code that describes the category of denial: Contract Obligation, Patient Responsibility, Other Adjustment, etc.
b. Select the specific entry in the list that describes the reason for denial.
c. Select whether you want to be notified by Popup message or by inclusion in the Daily Detail Report.
d. If you want ERAs that include this type of denial to be excluded from AutoPosting, select Skip Claim.
e. When finished, click Save.
Defaults tab
a. Specify any of the following preferences as needed:
· Remove ERA After Auto Posting - When selected, EDS will automatically remove the ERA from the Open Remittances list after it has posted to Open Dental.
· Deductible Applied for Claim - (Open Dental only) When selected, insurance deductibles are applied to procedures on claims.
· Allow Posting Multiple Checks (OpenDental) - When selected, this option allows you to select multiple ERAs to AutoPost in a single batch operation.
· Require Bank Number - When selected, EDS requires a bank number for the ERA before it will allow AutoPosting to Open Dental.
· Require Payment Group (OpenDental) - When selected, EDS requires a payment group number for the ERA before it will allow AutoPosting to Open Dental.
· Group By TID - When selected, a drop-down list appears on the Open Remittance tab which you can use to filter the list by tax ID. This is helpful for large practices with many providers.
· Distribute Tax - Payers generally apply sales tax payments as a separate line item; some offices include sales tax as a separate line item also, but others apply it as part of the fee. When selected, sales tax is automatically applied directly to the fees.
· Validate PPO Claim Matching - A payer may pay the PPO fee amounts rather than UCR fees. AutoPost compares the payer fee against the value in the Open Dental Ledger. When this option is selected, EDS flags differences as errors for the office wants to take note of.
· Bypass All Adjustments - When selected, AutoPost will be used for payments only and bypass all adjustments; adjustments will need to be handled and posted manually.
· Skip 'at Service' PPO claims w/ adjustments - When selected, any claim posting that requires any adjustment is automatically skipped.
3. When finished, click OK.