
Get the free DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION
Show details
This document provides instructions and requirements for providers to enroll in the Dental Electronic Remittance Advice (ERA) program through John Alden Life Insurance Co.
We are not affiliated with any brand or entity on this form
Get, Create, Make and Sign dental electronic remittance advice

Edit your dental electronic remittance advice form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.

Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.

Share your form instantly
Email, fax, or share your dental electronic remittance advice form via URL. You can also download, print, or export forms to your preferred cloud storage service.
How to edit dental electronic remittance advice online
To use the services of a skilled PDF editor, follow these steps below:
1
Set up an account. If you are a new user, click Start Free Trial and establish a profile.
2
Simply add a document. Select Add New from your Dashboard and import a file into the system by uploading it from your device or importing it via the cloud, online, or internal mail. Then click Begin editing.
3
Edit dental electronic remittance advice. Rearrange and rotate pages, insert new and alter existing texts, add new objects, and take advantage of other helpful tools. Click Done to apply changes and return to your Dashboard. Go to the Documents tab to access merging, splitting, locking, or unlocking functions.
4
Save your file. Select it from your list of records. Then, move your cursor to the right toolbar and choose one of the exporting options. You can save it in multiple formats, download it as a PDF, send it by email, or store it in the cloud, among other things.
pdfFiller makes dealing with documents a breeze. Create an account to find out!
Uncompromising security for your PDF editing and eSignature needs
Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
How to fill out dental electronic remittance advice

How to fill out DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION
01
Gather all necessary information such as your dental practice details, tax identification number, and contact information.
02
Obtain the DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION form from your insurance provider's website or office.
03
Fill in the required fields including practice name, address, and billing information accurately.
04
Specify the preferred delivery method for your ERA (e.g., electronic format).
05
Provide necessary signatures and dates to validate the form.
06
Submit the completed form to the appropriate insurance company or clearinghouse.
07
Follow up with the insurance provider to ensure your enrollment has been processed successfully.
Who needs DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION?
01
Dental practices that want to receive electronic payment information and remittance advice from insurance providers.
02
Dentists and dental offices that are transitioning from paper to electronic billing.
03
Healthcare providers looking to streamline their payment processing and reduce administrative burdens.
Fill
form
: Try Risk Free
People Also Ask about
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.
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 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.
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.
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.
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).
For pdfFiller’s FAQs
Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.
What is DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION?
Dental Electronic Remittance Advice (ERA) Enrollment Registration is the process by which dental providers register to receive electronic remittance advice from insurance payers. This process ensures that providers receive detailed electronic documentation regarding claims payments.
Who is required to file DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION?
Dental providers who wish to receive electronic remittance advice from payers are required to file the 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 must provide their practice details, including the National Provider Identifier (NPI), tax identification number, and contact information, as well as specify the payer they wish to enroll with.
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 a streamlined and efficient payment process, reducing paperwork and improving the speed at which providers receive payment information.
What information must be reported on DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION?
The information that must be reported includes the provider's NPI, tax identification number, practice name, address, phone number, and details of the payers with whom the provider wishes to enroll for receiving electronic remittance advice.
Fill out your dental electronic remittance advice online with pdfFiller!
pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Dental Electronic Remittance Advice is not the form you're looking for?Search for another form here.
Relevant keywords
Related Forms
If you believe that this page should be taken down, please follow our DMCA take down process
here
.
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.