ERA Enrollment

Welcome to the DentaQuest Online Electronic Remittance Advice (ERA) Enrollment Request page. Please be sure to complete all of the required fields (marked with a star) and click on Submit before leaving this screen. Partial entries will not be saved.

There are two steps to complete before an ERA can be sent to your organization via a 5010 X12 835 transaction

1) Complete the Enrollment to receive the ERA below.
2) Complete the Trading Partner Agreement which can be accessed via the link at the end of this enrollment page.

Please enter the following information: