Process ERA

In the Manage Module, click ERA.

Processing an ERA includes receiving the claim and finalizing the payment.

Double click on a row. Any claims that were split by the payer will be matched and processed together.

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. See ERA Raw Message.

Provider Adjustments: 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.

Find Claim Matches For Detached: Click to find claim matches for any detached claim (claims with a received status of N/A).

EOB Claim Details: Highlight a claim and select to view a breakdown of the claim. See EOB Claim Details.

Print: Print the ERA.

Double click on a claim in the Claims Paid grid to receive it. If a matching claim is found, this window will open.

Note: If a matching claim is not found, you will be asked to manually locate it. See ERA Match with Claim.

EOB Claim Adjustments, EOB Procedure Breakdown and EOB Totals are read only and for reference when entering payments.

Verify that payment amounts are accurate.

Click OK to mark the claim as received. An X will show in the Recd column of the main ERA window.

For each claim in the ERA, repeat steps 3 - 5.

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. Verify that the correct claims are attached and the amount is accurate.

If payment is paid via a prepaid insurance card and XCharge (OpenEdge) or PayConnect is enabled, use the XCharge of PayConnect 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.

Click OK again to finalize the payment.

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: Supplemental payments, claim corrections, and claim reversals can be done by processing an ERA as normal.