Dental ERA auto-posting: how it works
Dental ERA auto-posting reads the 835 file a payer sends, matches each payment to its claim in your practice management system and enters the payment and write-off on each procedure. It covers only payers you are enrolled with for ERAs, and it stops at unmatched claims, paper EOBs, virtual cards and the bank.
Book a demoBy the ScoutIQ AI teamPublished 6 min read
Key takeaways
- ERA auto-posting reads the 835 file a payer sends and enters each line on its procedure in your practice management system.
- It only covers payers you are enrolled with for ERAs. Everyone else keeps sending paper.
- It does the clean cases well. Unmatched claims, changed codes, secondaries and takebacks still need a person.
- Paper EOBs, portal PDFs and most virtual card remittances have no 835, so they never reach auto-posting.
- Posting is not reconciliation: each EFT still has to be matched to the bank and booked.
What ERA auto-posting is
An ERA, an electronic remittance advice, is the payer’s explanation of a payment as a standard file: the ASC X12 835. It lists every claim the payment covers and, for each procedure, the billed, allowed and paid amounts and the adjustment codes that explain the difference.
ERA auto-posting is your practice management system reading that file and doing what a biller does by hand from a paper EOB. It finds the claim, enters the payment and the write-off on each procedure, and leaves the patient’s share as a balance. Done well, the clean cases take no one’s time and the team works only the exceptions.
How it works, step by step
The payer pays and sends an 835
When a payer settles a claim, it sends the ERA, the X12 835 file, usually through your clearinghouse, along with the EFT or check.
One 835 can cover many claims and many patients. It carries a trace number that also appears on the EFT deposit, which is what ties the remittance to the money later.
The practice system imports the file
The clearinghouse delivers the 835 into your practice management system, or you download it and import it.
If ERAs are printed from the clearinghouse’s website and keyed in, nothing is automated yet. Direct delivery is the first thing to check.
Each claim payment is matched to its claim
The system looks for the claim each payment answers, by patient, subscriber, claim number and date of service.
A claim sent outside the system, or a payer that reports different patient details, leaves the payment unmatched. Someone has to attach it by hand.
Each line is posted to its procedure
The paid amount goes on the procedure, the contractual adjustment becomes the write-off, and the patient’s share stays as a balance.
The adjustment codes on each line say why the payer paid less than billed, such as a contractual write-off or what the patient owes. The section on what auto-posting leaves explains how to read them.
The payment is finalized and put on a deposit
The insurance payment is saved once, with its EFT trace or check number, and added to a deposit.
How much of steps three to five happens without a person depends on the system, its version and your settings.
Auto-posting sees only payers that send you an 835. To bring more payers onto it, enroll for ERAs and EFT together with each one; see EFT and ERA enrollment.
ERA auto-posting in Dentrix, Eaglesoft and Open Dental
Dentrix, Eaglesoft and Open Dental all work with ERAs. What differs is how much each one applies without a person, and that depends on the version and the setup.
| System | What it does with ERAs | What to check |
|---|---|---|
| Dentrix | Works with electronic remittances when it is connected to a clearinghouse that delivers them and you are enrolled for ERAs with each payer | How much applies automatically depends on your version and setup |
| Eaglesoft | Works with electronic remittances when it is set up with a supported clearinghouse and you are enrolled for ERAs with each payer | What it applies automatically depends on your version and setup |
| Open Dental | Imports ERAs from your clearinghouse, matches them to claims and enters payments and write-offs per procedure | Recent versions include settings for how much is processed without review |
| Other systems | Varies by system and version | Check your vendor’s documentation for what posts without review |
About screens and settings
What it leaves for a person
ERA auto-posting handles the clean case: an enrolled payer, a claim sent from your system, the procedures paid as billed. The rest still lands on someone’s desk, and that is where the money is.
| Case | What auto-posting does | What a person does |
|---|---|---|
| ERA from an enrolled payer that matches its claim | Payment and write-off entered per procedure | Review what your settings hold for review |
| ERA that does not match a claim | Left unmatched | Find the claim and attach the payment |
| Line paid on a different code, split or bundled | May not map to a procedure | Decide where the payment belongs and post it there |
| Secondary insurance | Primary posted | Send the secondary with the primary EOB, then post it against what is left |
| Takeback or recoupment (a negative line) | Varies | Reverse it on the original claim, not on the new one |
| Denied or short-paid line | Posted as the payer reported it | Read the reason code, decide whether to appeal, note the appeal date |
| Paper EOB, portal PDF or virtual card PDF remittance | Nothing: there is no 835 | Read and post every line by hand |
| The EFT deposit | Nothing: posting is not the bank | Match it to the ERA by trace number and amount, then book it |
Read the codes on each line with the CARC and RARC guide, and check each allowed amount against your contract with how to find underpayments. For the paper side, see posting paper EOBs and checks.
Posting is not reconciliation
A posted ERA says what the payer meant to pay. Only the bank says what arrived. Match each EFT to its ERA by the trace number and the amount, each check to its EOB, and each virtual card payout, net of the fee, to the remittance it pays. Then book the deposits and fees to your accounting system.
Skipping this step is how money goes missing in plain sight. At Todaro Dental, 178 of 185 insurance deposits matched automatically. The other 7, $4,358, had reached the bank but were never posted. See how to reconcile dental deposits in QuickBooks.
How ScoutIQ handles it
ScoutIQ does the posting ERA auto-posting cannot reach. It reads ERAs from your clearinghouse and also paper EOBs and checks sent to a ScoutIQ PO Box, staff uploads and the payer portals it checks, and posts every line into your practice management system. 95% of insurance payments match their EOB with no human review; short pays and denials go to a queue with the payer’s reason and the days left to appeal.
Every EFT, check and virtual card is matched to the bank deposit and booked to QuickBooks or Xero. ScoutIQ works on 59 practice management systems, does not submit claims, and most practices are live in 48 hours.
ScoutIQ product
Insurance Billing Automation
Sources
Insurance Billing Automation
ERAs and EOBs read; EFT, check and card payments reconciled.
See Insurance Billing Automation