Open Dental ERA auto-posting: how it works
Open Dental ERA auto-posting imports the 835 file from your clearinghouse, matches it to the claim and enters the payment and write-off on each procedure. It covers only payers that send ERAs, and it stops at unmatched claims, paper EOBs and the bank. Here is what it does, where it stops and how to set it up.
Book a demoBy Dr. Mark Haddad, endodontist and DSO co-founderPublished 6 min read
Key takeaways
- ERA auto-posting works from the 835 file: it only covers payers you are enrolled with for ERAs.
- It does the clean cases well. Unmatched claims, changed codes, secondaries and takebacks still need a person.
- Paper EOBs, portal PDFs and 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.
- Measured at Todaro Dental on Open Dental: 98% of electronic insurance dollars matched automatically. The 7 deposits that did not had reached the bank but were never posted.
What ERA auto-posting does in Open Dental
An ERA is the electronic version of an EOB, the ASC X12 835 file. Open Dental can import ERAs from your clearinghouse and use them to receive claims: each ERA is matched to its claim, and the paid amount and the write-off are entered on each procedure, the same work a biller does by hand from a paper EOB.
After that, the insurance payment is finalized, so it exists as one payment with its check or EFT reference, and placed on a deposit. How much of this happens without a person depends on your version and your settings.
About screens and settings
Where auto-posting stops
ERA auto-posting handles the clean case well: an enrolled payer, a claim sent from Open Dental, the procedures paid as billed. The rest still lands on someone’s desk.
| 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, under your settings | Review what your settings hold for review |
| ERA that does not match a claim | Left unmatched | Find the claim, often sent outside Open Dental or with different patient details, and attach it |
| 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 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 for the write-off on each line, see PPO fee schedules.
How to set up ERA auto-posting
Enroll for ERAs with each payer
Auto-posting only sees payers that send you an 835. Enroll through your clearinghouse, and enroll for EFT at the same time.
Pairing ERA and EFT enrollment gives each deposit a trace number that matches its ERA. Payers you are not enrolled with keep sending paper. See EFT and ERA enrollment in the glossary.
Connect the clearinghouse to Open Dental
Make sure ERAs are delivered into Open Dental, not only to the clearinghouse’s own website.
If ERAs are being downloaded and printed, the work is still manual. Check with your clearinghouse and Open Dental’s documentation that files are imported directly.
Choose how much posts without review
Recent versions of Open Dental include ERA automation settings that decide how much is processed without a person reviewing it first.
The options and their names depend on your version, so check the Open Dental manual before relying on them. A sensible start is to review everything for two weeks, then release the payers whose ERAs post cleanly.
Keep fee schedules and write-off types current
Load each payer’s current fee schedule and use one adjustment type for contractual write-offs.
An out-of-date fee schedule makes every estimate wrong and hides underpayments inside write-offs. A consistent write-off type keeps reports comparable month to month.
Work the exceptions every day
Unmatched ERAs, denied lines and anything held for review go to one list with an owner.
The value of auto-posting is that the clean cases take no time. The exceptions are where the money is, and they age if nobody owns them.
Then run this every posting day:
- Every ERA received today is imported and either posted or on the exception list.
- Unmatched ERAs are attached to their claims, or the reason they cannot be is written down.
- Paper EOBs, portal PDFs and virtual cards received today are posted by hand.
- Each insurance payment is finalized and on a deposit.
- Each deposit matches the bank by amount and trace or check number.
- Denials and short pays have an owner and an appeal date.
After posting: deposits, the bank and the books
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 card 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 in Open Dental. See reconciliation and payment reconciliation.
What it looks like at two Open Dental practices
Two of ScoutIQ’s measured customers run Open Dental. Each figure is measured in the practice’s own Open Dental records and ScoutIQ payment records.
| Practice | Measured | Result |
|---|---|---|
| Todaro Dental, Livonia, MI | Insurance payments through ScoutIQ | 76%, with 330 claims posted from the EOB since Insurance Billing went live, a median of 6 minutes after the EOB was uploaded |
| Todaro Dental | Electronic insurance dollars matched automatically | 98%, 178 of 185 deposits |
| Todaro Dental | Days in A/R | 13.3, from 18.6: 28% faster |
| Polish Dentistry, Houston | Online patient payments posted to Open Dental with no keying | 146 of 147 |
Todaro’s case study lists paper checks, payer websites, virtual cards and denials as the next parts of Insurance Billing to turn on. Full numbers and method: Todaro Dental and Polish Dentistry.
How ScoutIQ handles it
ScoutIQ does the posting Open Dental’s 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 Open Dental. 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
Insurance Billing Automation
ERAs and EOBs read; EFT, check and card payments reconciled.
See Insurance Billing Automation