How to Process ERA in Open Dental

Processing an Electronic Remittance Advice (ERA) manually can feel like a guessing game if you aren't sure where the data is supposed to go. When you don't use the built-in tools to open dental process ERA files, you risk double-entering payments, misapplying write-offs, or leaving claims in a "Sent" status indefinitely, which ruins your aging reports.

Before You Start

Before you can process an ERA, ensure the following prerequisites are met:

1. Clearinghouse Enrollment: You must be enrolled with your clearinghouse and participating insurance carriers to receive ERAs.
2. Clearinghouse Setup: In the Manage Module, click Clearinghouse. Ensure your clearinghouse is configured to "Download ERAs" and has a valid report path defined.
3. Permissions: Ensure your user account has the "Insurance Payment Create" permission enabled.
4. Service Status: The Open Dental Service must be running on your server to facilitate the automatic download of reports.

Step-by-Step Instructions

Follow these steps to manually process an ERA in Open Dental version 25.2 or 25.3:

1. Open the ERA Window: Go to the Manage Module and click the ERAs button.
2. Select the ERA: The ERAs window will open, displaying a list of downloaded electronic EOBs. Locate the ERA you wish to process and double-click it to open the ERA - Electronic EOB window.
3. Review Claims: In the Claims Paid grid, you will see all claims associated with this ERA.
4. Process Individual Claims: Double-click on a specific claim in the grid to open the Verify and Enter Payment window.
   • Review the payment information against the EOB.
   • If necessary, use the By Procedure button to distribute payments to specific procedures.
   • Verify the deductible and write-off amounts.
   • Click Save to mark the claim as "Received."
5. Repeat: Repeat step 4 for every claim listed in the Claims Paid grid until every claim shows an "X" in the Recd column.
6. Finalize Payment: Once all claims are marked as received, click the Finalize Payment button at the bottom of the ERA - Electronic EOB window.
7. Confirm Details: The Edit Insurance Payment window will open. Verify the check number, payment date, and total amount. Click Save to finalize the batch insurance payment.

Common Mistakes

• Ignoring the "Recd" Column: If you finalize a payment before every claim in the ERA is marked with an "X" in the Recd column, those specific claims will remain in a "Sent" status, causing them to appear incorrectly on your Outstanding Insurance Claims Report.
• Forgetting to Distribute Payments: If you click Save without verifying that the payment is applied to the correct procedures, the system may apply the entire payment to the first procedure, which can lead to incorrect patient balance calculations. Always verify the breakdown before saving.

Related Scenarios

If you need to handle a payment that was not part of an electronic file, see . If you find that a claim was processed incorrectly and needs to be reopened, check your version's manual for instructions on .

Track all your outstanding claims at a glance with DentalCanvas — a visual dashboard that shows your insurance aging, pending claims, and collection trends in real time.

This article is provided by opendentalsupport.com, an independent community resource. We are not affiliated with Open Dental Software, Inc.