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THANK YOU FOR YOUR INTEREST IN THE EDS ERA ENROLLMENT SERVICE POWERED BY
DENTALXCHANGE AND ZENTIST!

THE ERA, OR 835, IS THE ELECTRONIC TRANSACTION THAT PROVIDES CLAIM PAYMENT
INFORMATION.

WE ARE READY TO SUPPORT YOUR DENTAL PRACTICE(S) IN RE/ESTABLISHING ERA DATA
FLOW.

Here are the steps to get there:

1. Complete and submit this online form with the required information so we can
kickstart the ERA enrollment process.

2. As part of this ERA enrollment process, we will establish your access to
DentalXChange portal where you’ll be able to see the progress and completion of
enrollments, as well as receive ERAs.

3. Your dental practice management software vendor will also receive your ERAs
for further processing and delivery to support your claim payment posting needs.

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Question 1
1

Are you affiliated with a DSO or dental group? If so, what is the name of that
organization?

If you're not affiliated with a DSO, continue to the next question.