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

This document serves as an enrollment form for providers wishing to participate in Dental Electronic Remittance Advice (ERA) through New York Medicaid, detailing necessary information such as provider

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 that allows dental providers to receive electronic remittance advice from insurance payers, facilitating faster and more efficient processing of claims payments.

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

Dental providers who wish to receive payments electronically from insurance 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 must complete the required forms with accurate information about their practice, including tax identification numbers and the designated contact for electronic communications.

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

The purpose of the Dental Electronic Remittance Advice (ERA) Enrollment Registration is to streamline the claims payment process by ensuring that dental providers can receive and process remittance advice electronically.

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 name, tax ID, NPI number, contact information, and selected delivery method for electronic remittances.