Get the free DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION

This document serves as an enrollment registration form for providers to receive Electronic Remittance Advice (ERA) from Delta Dental of Illinois, requiring direct deposit participation.

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 dental insurance provider's website or customer service.
2. Fill in practice information, including the practice name, address, and phone number.
3. Provide the Tax Identification Number (TIN) and National Provider Identifier (NPI) for your dental practice.
4. Indicate the specific payers you wish to enroll with for electronic remittance advice.
5. Sign the form to authorize the submission of the enrollment request.
6. Submit the completed form as instructed, either electronically or by mailing it to the designated address.
7. Follow up with your insurance provider to confirm the receipt of your enrollment request.

Who needs DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION?

1. Dental practices that provide services and wish to receive electronic remittance advice to streamline payment processes.
2. Dentists and dental offices that want to reduce paperwork and improve efficiency in billing and payment reconciliation.
3. Any dental provider seeking faster access to payment information and a more efficient way to manage claims.

People Also Ask about

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.

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 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).

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 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.

For pdfFiller’s FAQs

What is DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION?

Dental Electronic Remittance Advice (ERA) Enrollment Registration is a process through which dental providers enroll to receive electronic remittance advice from payers. The ERA provides detailed information about claims processed by insurance companies and facilitates faster and more efficient payment reconciliation.

Who is required to file DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION?

Dental providers or practices that wish to receive electronic remittance information instead of paper explanations of benefits (EOBs) are required to file for 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 gather necessary information such as the National Provider Identifier (NPI), tax ID, contact details, and preferred method of receiving ERA. The form usually requires submission to the respective payer or clearinghouse.

What is the purpose of DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION?

The purpose of DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION is to enable dental providers to receive electronic notifications regarding payment details, allowing for quicker claim reconciliation and reducing administrative costs associated with paper remittances.

What information must be reported on DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION?

The information that must be reported on the DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION includes the provider's NPI, tax ID, practice name, address, contact information, preferred method of receipt, and any payer-specific requirements.