Get the free Dental Electronic Remittance Advice (ERA) Enrollment Registration

This document is a registration form for providers to enroll in the Dental Electronic Remittance Advice (ERA) program associated with Medicaid of Ohio. It provides instructions for completing the

How to fill out dental electronic remittance advice

How to fill out Dental Electronic Remittance Advice (ERA) Enrollment Registration

1. Obtain the Dental Electronic Remittance Advice (ERA) Enrollment Registration form from your insurance payer's website or by contacting their provider services.
2. Carefully read the instructions provided in the form to understand the requirements.
3. Fill out the provider's information section, including the provider's name, NPI number, and tax identification information.
4. Include the practice address and contact information to ensure accurate communication.
5. Indicate the specific dental plans for which you are enrolling in the ERA program.
6. Provide necessary banking information for electronic funds transfer (EFT) if required by the payer.
7. Sign and date the form to authorize the enrollment.
8. Submit the completed form according to the payer’s instructions, which may include mailing, faxing, or submitting online.
9. Keep a copy of the submitted form for your records and follow up with the payer to confirm enrollment.

Who needs Dental Electronic Remittance Advice (ERA) Enrollment Registration?

1. Dental providers and practices that wish to receive Electronic Remittance Advices (ERA) for insurance claims.
2. Practices that want to streamline their claims process and improve payment tracking.
3. Providers who require timely and accurate payment information from insurance payers.

People Also Ask about

What is an era electronic remittance advice?

An electronic remittance advice, or ERA, is an explanation from a health plan to a provider about a claim payment. An ERA explains how a health plan has adjusted claim charges based on factors like: Contract agreements. Secondary payers. Benefit coverage.

Is ERA the same as EFT?

Think of it this way: the ERA tells you what the payment is for, and the EFT puts the payment in your account. Using ERAs and EFTs helps billers post payments quickly. It also means you do not have to wait around for paper checks to arrive.

What is an era enrollment form?

Electronic Remittance Advice (ERA) or 835 file is the electronic remittance describing the payer, payee, payment amount, and other identifying information about the payment.

How do I enroll in EFT and ERA?

How do I enroll? Enroll for EFT/ERA through Payment Accelerator: Enroll online for Payment Accelerator, a free service, to start receiving benefits immediately. Or, download the Network Funding Agreement attach a voided check or bank letter and fax them to U.S. Bank toll-free at 1-877-755-3392.

How to set up EFT on availity?

Sign in to Availity and select the Claims Status & Payments and then Transaction Enrollment to enroll, update, or cancel EFT.

What is EFT ERA enrollment?

Program and enrollment. What is EFT/ERA? Electronic funds transfer (EFT) and electronic remittance advice (ERA) send money and remittances between payers, such as Kaiser Permanente, and providers electronically. EFT moves the money, and ERA is the detailed explanation of payment (EOP).

How do I receive an EFT?

In order to receive an EFT, you need to share your banking details with the person sending you one, including your institution number, your branch number and account number, and your transit number.

For pdfFiller’s FAQs

What is Dental Electronic Remittance Advice (ERA) Enrollment Registration?

Dental Electronic Remittance Advice (ERA) Enrollment Registration is a process by which dental providers can enroll to receive electronic remittance advice from payers. This allows for the electronic transmission of payment information and explanations of benefits.

Who is required to file Dental Electronic Remittance Advice (ERA) Enrollment Registration?

Dental providers, including dentists and dental practices that wish to receive electronic remittance advice from insurance companies or payers, are required to file Dental Electronic Remittance Advice (ERA) Enrollment Registration.

How to fill out Dental Electronic Remittance Advice (ERA) Enrollment Registration?

To fill out the Dental Electronic Remittance Advice (ERA) Enrollment Registration, providers need to complete the designated form with required information such as their National Provider Identifier (NPI), practice location, contact details, and payer-specific information as requested.

What is the purpose of Dental Electronic Remittance Advice (ERA) Enrollment Registration?

The purpose of Dental Electronic Remittance Advice (ERA) Enrollment Registration is to facilitate the electronic exchange of payment data between dental providers and payers, improving the efficiency and accuracy of billing processes.

What information must be reported on Dental Electronic Remittance Advice (ERA) Enrollment Registration?

The information that must be reported on Dental Electronic Remittance Advice (ERA) Enrollment Registration includes the provider's NPI, tax identification number, billing address, contact information, and any specific details related to the payers the provider is enrolled with.