ERA 835, also known as Electronic Remittance Advice format, is an electronic explanation of benefits (EOB) that can be electronically downloaded.
In the Manage Module, click ERAs.
Automatic or manually downloaded ERAs can be used to auto-populate insurance paid amounts in to claims to finalize insurance payments.
Set up Requirements
To start using ERAs, sign up for ERAs with your clearinghouse and participating insurance carriers.
Some setup is needed in Open Dental to enable ERAs. These steps should be performed on your server. If you have not setup your clearinghouse in Open Dental, see Clearinghouse Setup.
- Ensure the Open Dental Service is installed and running.
- In Clearinghouse Setup, check Receive Reports by Service
- In Clearinghouse Setup, double-click on your clearinghouse. Ensure Download ERAs is selected and that there is a designated report path. (i.e. C:\ClaimConnect\Report\).
- Ensure users have Permissions for Insurance Payment Create.
- In the Send Claims window, click Get Reports, select your clearinghouse, then check for a successful connection to your clearinghouse server.
- (Optional) Enable ERA Automation (automatic processing) in Manage Module Preferences.
Use the Electronic EOBs - ERA 835s window to view and manage ERAs. Claims will be matched with an ERA and if one is not found, you will be prompted to find the correct claim (see ERA Match with Claim).
Use the filter options to change the ERAs listed in the ERAs grid. Click refresh after each change. Filter options may change based on Enterprise Setup Manage settings.
- From/To: Change the date range. Click the down arrow to select dates from a calendar then click the up arrow to collapse the calendar. Click the W buttons to jump back or forward one week. Results are refreshed automatically when the date is changed.
- Amount Range: Only show ERAs within a certain payment amount range. Min = the minimum payment amount to show. Max = the maximum payment amount to show. Leave blank to show all ERAs regardless of payment amount.
- Control ID: Filter by Control ID. Only shows if enabled in Show Features.
- Carrier: Filter by carrier.
- Check# or EFT Trace#: Only show ERAs for a specific check number or EFT trace number.
- Clinic: Filter by clinic. If an ERA has more than one clinic, multiple will list in grid.
- Status: Filter by ERA processing status. By default, ERAs received in the last 7 days that have a status of unprocessed, partial, or not finalized will list.
- Unprocessed: ERAs that have not been processed at all (no claims are received).
- Partial: ERAs with some claims that are received, and others that are not.
- Not Finalized: ERAs with claims that are received, but still need to be finalized.
- Finalized: ERAs with a finalized payment.
- Automatable Carriers Only: Determines if all carriers display, or only carriers that allow ERA automation.
- Checked: Displays only carriers that allow ERA automation.
- Unchecked: Displays all carriers.
ERA Grid: Double-click on a claim to Process and view EOB Claim Details.
- Patient Name: Lists the patient on the ERA. If more than one patient is associated with an ERA, the number of claims on the ERA shows in the Patient Name column instead of a name.
- Carrier Name: Lists the carrier on the ERA.
- Status: Current status of the ERA.
- Date: Date of the ERA.
- Amount: Amount of the ERA.
- Clinic: Displays which Clinic the ERA is assigned to, or unassigned if not assigned to a clinic.
- Code: Code types are used to determine payment methods. The following codes are used:
- ACH: Automatic clearinghouse (Direct Deposit)
- CHK: Paper check
- NON: No payment issued
- FWT: Federal wire transfer
- BOP: Financial Institution Option
- ControlID: Transaction set control number. This number is assigned by the carrier and is used to identify the ERA group and interchange. Only shows if enabled in Show Features.
- Note: Displays notes entered on the ERA. Also displays a note if Automatic Processing was attempted, if Fully Automatic processing of ERAs is turned on in Manage Module Preferences.
ERAs can also be viewed and processed via the Insurance Claims window, History grid (see Send Claims).