Process an ERA
To process an ERA, you must receive each claim, and finalize the payment.
- In the Manage module, click ERAs to open the Electronic EOB window. Claims will show in this window only if they've already been downloaded to the Report Path. This can happen automatically or manually.
- Select your ERA to process. Select your ERA to process by double clicking on the row.
All claims in the ERA list under 'Claims Paid'. Right click a claim and select "Go to Account" to view patient's account information.
Raw Message: The electronic file sent by insurance. This is used for troubleshooting purposes.
Double click a row to open a simple window that can be used to copy text.
Detach Claim: Select one or more claims to detach from an EOB.
Detached claims will still list on ERA, but will show a received status of 'N/A' and will deduct the total from the payment amount.
EOB Claim Details: Highlight a claim and select to view a breakdown of the claim.
Print: Print grid of Electronic EOB.
- Receive a Claim. Receive a claim by double clicking a claim in the Claims Paid grid. If a matching claim is found, this window will open.
If a matching claim is not found, you will be asked to manually locate it. See Matching Claims and ERAs.
- Verify that payment amounts are accurate.
- The amounts for EOB totals should match the Totals amounts.
- The Total Payment row reflects "by total" payments. It may include payments for procedures that are not itemized on the ERA.
- Deductible: Click to move all deductible amounts to the selected row (it can be any row, including Total Payment).
- Writeoffs: For In-network PPO Plans, if you change insurance paid or deductible amounts, make sure to manually writeoff and out of network amounts as well
EOB Claim Adjustments, EOB Procedure Breakdown and EOB Totals are read only and for reference when entering payments.
- Click OK to mark the claim as 'received'. An X will show in the Recd column of the main Electronic Remittance Advice window.
- For each claim in the ERA, repeat steps 3 - 5.
- Finalize Payment. When every claim in the ERA is marked 'Received', click Finalize Payment.
- Most information will be auto-populated. Enter any other details if needed.
- Click OK to open the Insurance Payment window and verify that the correct claims are attached and the amount is accurate.
- Click OK again to finalize the payment.
Prepaid Insurance Cards: If payment is paid via a prepaid insurance card and X-Charge or PayConnect is enabled, you can process the payment. Buttons are only visible when X-Charge or Payconnect is enabled. Click a button to process the payment. When the transaction is complete, the Edit Insurance Payment window will still be open and transaction details will show in the Note. See Credit Card Payments.
Secondary Claims: When a payment from a primary claim is finalized, Open Dental will give a message of patient's with secondary claims to send.
Supplemental Payments: Open Dental cannot enter Supplemental Payments via ERA at this time. Detach the claim from ERA and post supplemental payment manually.