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Electronic Attachments  

To send and manage electronic claim attachments, we recommend using NEA FastAttach with the Claim Connect clearinghouse. For NEA FastAttach registration and download see http://www.nea-fast.com/.

ClaimConnect also has an attachment service through their website. Contact ClaimConnect for more information.

NEA and other clearinghouses: NEA can be used with other clearinghouses but you will often have to double enter claim information. After uploading the images, copy/paste the NEA# into the Claim Note field on the Edit Claim window (enter the number first e.g. NEA#1234532 other notes go after number.)

NEA Fast Attach with Claim Connect
Primary claims: The following process is used when sending primary claim attachments using Claim Connect and NEA FastAttach.

  1. Have NEA FastAttach running in the background on your computer. To log in to NEA, double click the NEA icon in the taskbar, then click Launch. 
  2. Send the claims to the Claim Connect clearinghouse using Open Dental.
  3. If Claim Connect determines that the carrier requires an attachment for the claim, they will notify NEA FastAttach.
  4. On your computer screen, NEA FastAttach will notify you by changing its icon from blue to flashing red.
  5. Upload attachments to NEA FastAttach. There are two options for gathering attachments. See Uploading Attachments below.
  6. Enter the NEA attachment ID number on the Edit Claim window, Attachments tab for reference.


  • You must set up the patient in NEA Fast Attach in order to receive notifications.
  • Attachments are managed at the clearinghouse level if required by the carrier. If you are not notified that an attachment is needed, contact the clearinghouse or carrier. Open Dental is only a place to record attachment information.

Secondary claims: When sending Secondary Claims that need attachments (e.g. the primary EOB), the process may be slightly different depending on your clearinghouse. Some may require that you upload the attachment to NEA FastAttach first and send the attachment ID number with the claim.

  1. Manually upload the attachments to NEA.
  2. Open the secondary claim in Open Dental and click the Attachments tab.
  3. Under Attachments:
    - Select Electronically.
    - Enter the NEA attachment ID number.
    - Do not select a type unless Claim Connect specifies to.
  4. Send the secondary claim to the clearinghouse.

Uploading Attachments to NEA FastAttach
You have two ways to capture and upload attachments to NEA FastAttach.

Option 1: NEA Screen Capture: Based on user feedback, NEA Screen Capture is the simplest way to capture and send attachments.

  1. In NEA, double click on the first claim that needs attachments.  Required attachments are listed on the left.
  2. Highlight the first procedure code that requires an attachment (usually x-ray, perio chart, etc.), then click Screen Capture.
  3. Locate your image (usually in the Images module or Perio window). Click the Draw Rectangle button and outline the entire image. Click Attach.
  4. Enter details about the image: Non-XRay, By tooth, etc.
  5. Select the Type.
  6. Click Next.
  7. On the confirmation notification, click Close.
  8. Once all attachments have been captured, click Send.
  9. Enter the NEA# (copy/paste) into the Attachment ID field on the Attachments tab, Edit Claim window (informational only).

Option 2: Export from Open Dental / Upload to NEA:  In Open Dental, attachments can be exported to one temporary folder, then uploaded to NEA. The advantage to this method is that it records which images are attached to the claim.  The temporary folder is set up by you. Just create the folder (e.g. NEA attachments), then specify the path to the folder in Account Module Preferences, 'Claim Attachment Export Path'.

When sending attachments:

  1. When creating the claim, select the attachments to send to the attachment folder. On the Edit Claim window, Attachments tab:
    - Click Add to select images from the Images module.
    - Click Perio to select the current Perio chart including up to 5 historical measurements.
    - Click Export to send the selected images to the attachment folder.
  2. When NEA requests attachments, manually upload the images from the folder to NEA.
  3. Copy/Paste the ID number NEA provides into the Attachment ID field on the Attachments tab, Edit Claim window (informational only).
  4. We recommend removing the files from the attachment folder to clear it for the next claim.

Technical Details
When an e-claim is sent to Claim Connect: 

  • Each procedure is compared with the carrier's requirements.
  • If the carrier requires an attachment, such as an x-ray, perio chart, narrative, or EOB, then the claim is put in a hold status.
  • Claim Connect sends the claim info to the NEA server and receives back an NEA#.  The NEA# is inserted into the claim.
  • The next time you open the NEA client program, it synchs with the NEA server and displays a list of claims that are awaiting attachments.  You then need to upload the attachments to the NEA client program. 

Questions and Answers
Q:  My claim should require an attachment, but it did not show up in NEA FastAttach, what should I do?
A:  First make sure you have signed up with Claim Connect and agreed to the package.  If this is a new site, you may have signed up for NEA Fast Attach, but never agreed to the package for that site\clinic.  Log in at www.dentalxchange.com to sign up and agree. 

If some claims from the same office are working correctly (prompting you for the attachments), but others are not, contact Claim Connect to try to resolve. Have the specific claims at hand and keep track of who you talk to. If you cannot resolve it, call Open Dental and we will work with you and Claim Connect. We can only act as an advocate to facilitate resolution because we only send the claim to the clearinghouse; we do not decide what procedures require attachments.


Open Dental Software 1-503-363-5432