Electronic EOBs (ERAs)

Electronic EOBs (ERAs)

An electronic Explanation of Benefits (EOB), also known as Electronic Remittance Advice (ERA), or Electronic Data Interchange (EDI) 835 file, is a digital version of a paper EOB for an insurance claim payment. It includes details such as:
  1. Amounts paid
  2. Reasons for denials or adjustments
  3. Patient financial responsibility 
  4. Payment method (check, electronic funds transfer, etc.)
Practices use ERAs because they're more efficient than paper claims and can improve payment speed. Payments usually come separately even if a practice is utilizing electronic funds transfer (EFT) though.

Getting Started with Electronic EOBs (ERAs)

Not all insurance carriers or clearinghouses offer ERAs or allow you to download them automatically. A few that do include:
  1. ClaimConnect by DentalXChange
  2. Denti-Cal
  3. Change Healthcare 
  4. Electronic Dental Services
If automatic downloads are not available, download ERAs manually to the Claim Report Path in Clearinghouse Setup.

Managing Electronic EOBs (ERAs)

Once ERAs are downloaded, they can be processed and viewed in two ways in the Manage Module:
  1. Clicking the "ERA" button.
  2. Clicking the "Send Claims" button, then clicking in the grid within the "Insurance Claims" window.
The image below shows the Electronic EOBs window that appears after clicking the ERA button.


By default, ERAs received in the past seven days with a status of unprocessed, partial, or not finalized will display on the list. Claims are automatically matched with the right ERA but the match cannot be found, you'll be prompted to find the correct one. 

If an ERA relates to more than one patient, the number of claims on the ERA will display in the Patient Name column instead of the name. 

Doubleclick on a claim to Process and view the EOB Claim Details.

If a claim has special circumstances, add the claim to the Outstanding Insurance Report and set a tracking status. 

Filtering Electronic EOBs (ERAs)

There are multiple ways to filter electronic EOBs. Click the "Refresh" button after making a selection to view the filtered list.
  1. From / To date fields allow you to choose the date range.
  2. Amount Range lets you input a minimum and maximum payment amount.
  3. Control ID will appear only if enabled in Show Features (Setup > Advanced Setup > Show Features).
  4. Carrier allows you to filter by insurance carrier.
  5. Check# or EFT Trace# fields allow you to narrow the list to ERAs with a specific check number or EFT trace number.
  6. Clinic filters by clinic. 
  7. Status allows you to filter based on the following status types:
    1. Unprocessed: The ERA has not been processed/ no claims have been received.
    2. Partial: Some of the claims associated with the ERA have been processed.
    3. Not Finalized: All claims associated with the ERA have been received, but need to be finalized.
    4. Finalized: Payment for the ERA is finalized.

Code Types

A "Code Type," or payment method, will also display. These include:
  1. ACH: Automated Clearing House/ Direct Deposit
  2. CHK: Paper check
  3. NON: No payment
  4. FWT: Federal Wire Transfer

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