Empowering Dentistry with EFT & ERA Technology App

Chris Haines

As my journey continues in Dentistry I’m excited to share all the new technology regarding EFT & ERA that has been developed and how some practices are embracing it more and learning how to improve their Practice insurance systems, how to simplify the setup, and completing the enrollment process with all partners using technology.

Dentistry is finally catching up to the Medical Industry when it comes to implementing digitalization for receiving payment from insurance carriers.

Remote billing service providers for Dental practices have exploded in the last few years to help simplify administrative tasks when it comes to insurance processes.

Back in 2009, when I was working in a Dental practice doing insurance, I had a letter come across my desk from MetLife insurance offering EFT payment. Back then, there were not a lot of Dental practices that had the knowledge of what EFT payment was all about.

By implementing this one carrier for EFT payment in the practice where I was working, it grew into a passion for how Dental practices could achieve this EFT & ERA technology system to access in one place and keep track of the set-up process for receiving electronic payment from Insurance carriers.

With all the new technology in dentistry becoming digitized, there is a need for efficiency, achieving fewer expenses, EFT & ERA technology system investment, and expert assistance for productivity and cost-effectiveness.

Sending “clean claims” takes expertise, time, clinical knowledge, and hours to follow up.

Data from Remits and EOB’S/EOP’S, create in real-time EDI 835 files that streamline the processing of Dental payments in a more efficient process. The underlying factor necessary in operating a dental office is cash flow.

The main trend in EFT & ERA is toward technology for providers and payers that is easy to use, cloud-based to be accessible from home offices, and customizable to each payer network’s needs.

EFT without ERA is an administrative suicide. You need both to achieve administrative simplification.

These needs will become even more varied for each provider.

The dental profession faces a number of emerging Insurance changes and challenges, which forces practices to stay informed on how to implement these changes.

Practices need to keep up with this rollout of virtual credit card payments. Basically, these VCC payments are insurance companies forcing practices to make a decision on how to receive payment.

VCC opt-out payments are only good for 90 days, after 3 months, they auto-enroll you back to VCC and state there is a loophole that allows them to do this. This has forced practices to call and request their method of payment. ( Check , VCC, EFT) .

As of July 1st, 2023, practices will no longer be getting a fax or email regarding a VCP payment because it is going digital.

The TRN is designed to help providers confidently match EFT deposit with corresponding ERA’s that are deposited in the bank account.

Three very important features to a bank deposit are the TRN number, name of insurance company, and deposit amount.

The benefit of this is huge, being it is available electronically and gives you access to the information it contains sooner than with a mailed paper EOB. Administrative savings are realized as a result of the paperwork reduction and the ERA can be scanned into the patient file.

Combined, they make achieving and sustaining a stable cash flow a difficult yet still essential part of any management plan.

To help Dental industry providers recognize and realize the benefits of automation using the healthcare EFT standard and ERA, this technology proved that practices of all sizes can achieve cost savings and benefits from converting their claims reimbursements payments from paper checks to the EFT standard transaction and automating the reconciliation and posting process using the ERA.

Practices no longer need to wait for your Explanation of Benefits (EOB) to arrive in the mail. Once you enroll in ERA, you can access the information you need to reconcile your patient accounts as soon as it is available to you.

Each ERA will have a trace number (TRN) attached and name of insurance company to give you the ability to automatically re-associate the claim remittance information you receive from the clearinghouse.

BENEFITS ACHIEVED ACROSS PRACTICES INCLUDED:

• iaster patient billing, as EFT payments are received faster, allowing for quicker secondary billing and billing of patient responsibility.

• Electronic verification facilitated through a Dental practice partnership with clearinghouses, offices may experience faster turnaround times and fewer returned or denied claims due to eligibility issues. Inefficient systems and inaccurate information at the start of the claim process are major contributors to poor cash flow, which is detrimental to the financial stability of a practice. Make sure to spend the proper amount of effort before the claim is submitted to ensure the best possible remittance collection.

• It may not be surprising to learn that two-thirds of denied dental claims are linked to eligibility issues. Many of those errors are rooted in either a failure to check eligibility or the use of inaccurate eligibility data. That is why eligibility verification is an important step, even for existing patients.

Insurance plans shift frequently, and patients are not always aware if— or how—their benefits have changed.

• The first step to having a healthy revenue cycle is for office staff to check with insurance carriers on the eligibility and benefits of patients the day before they walk into a practice.

• Real-time is by far the most efficient verification of dental insurance breakdowns and continues to be one of THE most important tools in a practice

• Reduced posting errors through automation of EFT and ERA.

• Reduced processing costs.

• Improved payment cycle within 2-7 days.

• Threat of lost and stolen checks is eliminated.

• Drastically cut down on the possibility of embezzlement in the practice.

TOOLS FOR IMPLEMENTING AN EFT & ERA TECHNOLOGY PAYMENT SYSTEM:

• Choose a clearinghouse that offers integration of both EFT & ERA, it will benefit the insurance process.

• Integrate x-ray attachments, perio charting, narrative, intraoral images, and secondary insurance for submission.

• Access the insurance carrier website for benefit verification or hire an outsourcing company.

• Spend the proper amount of effort before the claim is submitted to ensure the best practice remittance collection.

SYSTEM OF SAFEGUARDING AGAINST EMBEZZLEMENT:

• Doctor-only privileges to deposit only account or

• Doctors can assign Insurance coordinators with their own username/password to their bank account for viewing privileges only

• Set up a secure environment for receiving EFTs

• Say NO to virtual credit card payments

Banks and Dental Insurance companies must meet all privacy and security standards with password-encrypted account entry in a highly protected format that is federally mandated.

Some practices have had over $100,000 in unclaimed claims revenue due to errors and omissions coming from their office processing systems. Before you blame the payers, check your internal systems!

With an EFT & ERA Technology payment system, you can learn how to streamline your internal processes so that you get paid faster.

My passion for Technology in Dentistry has led me to achieve a platform for practices to access all in one place with an EFT & ERA App that is essentially “do it yourself” practice management consulting, that will supply the syllabus, instructions for setting up EFT & ERA for receiving payments electronically, and guidance on how to institute this technology.

In short, the app engages the Provider, clearinghouse, and payer in simplifying the Dental electronic payment setup and completing the enrollment process with all partners, with the stepby-step guidance, tools, support, and accountability you need to achieve better cash flow.

A new era in Dentistry has begun, if dentists want to increase the cash flow coming out of their practice, he/she needs to learn how to manage their businesses or hire the right experienced Technology professional with the help of their management team to help them do so.

And the journey continues!

Chris Haines is the founder of Dental WebSmart Insurance Solutions providing implementation and training of EFT & ERA Technology systems.

Her passion for Technology has lead her to developing an EFT & ERA App that is essentially “do it yourself” management consulting, supplying the syllabus, instructions, and guidance for instituting this process.