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Inside an EOB

This is the screen you get after you click a file on the EOB Dashboard. One remittance, all of its patients, and the place you actually approve and post.

The page has two layers:

  1. The whole file, with two tabs: Posting (the patient list — “who is on this check?”) and Payment Analysis (did the insurer pay the contracted fee?).
  2. One patient at a time, with four tabs: EOB Review, Payment Analysis, Open Dental, and Audit.

Posting is covered on this page. Both Payment Analysis tabs have their own page: Payment Analysis inside an EOB.

Confirm remittance layout

If the file is still waiting for confirmation, you will not see patients yet. Instead:

  • Banner title: Confirm remittance layout
  • Body like: “This looks like Cigna. Use Confirm & process below…”
  • Empty state: Layout detected — confirm to extract
  • Button: Confirm & process {payer} (or Confirm & process EOB) — may show Processing…

You need Upload EOBs permission to process. Viewers can open the file but cannot confirm.

After confirm finishes, the patient list appears as usual. Full map: Statuses. Upload modes: EOB Dashboard.

The patient list (Posting tab)

This is the Posting tab, and it is where the file opens. Each row is a person Ordo read from the PDF. You will see name, subscriber ID, claim #, date of service (DOS), procedure count, amount, Status, and a Remark column explaining what the status means and what to do next.

A Workflow guide button on this page (and on a single-patient header) opens a short map of which actions are allowed at each status. The full version is Statuses.

Search, sort, pages

  • Search by name, identifiers, subscriber, or claim-ish text.
  • Click a column header to sort.
  • Change page size (5, 10, 25, 50) if the remittance is long.

Checkboxes and Fetch Open Dental

This is the most important habit on the page.

  1. Tick one or more patients you are about to work.
  2. Click Fetch Open Dental.
  3. Wait until the fetch finishes. The button shows Fetching Open Dental… and the Open Dental tab shows a spinner until the chart data is back. Do not open the patient mid-fetch.
  4. Then open a patient.

Fetch loads matching chart data from Ordo’s copy of Open Dental. Opening a patient before fetch only shows the EOB side. People often think the Open Dental tab is “broken” when they skipped this step.

Example. Mike ticks Maria Santos and James Lee, clicks Fetch Open Dental, then opens Maria. The Open Dental tab now lists claim candidates. If he had opened Maria first, he would have stared at an empty or EOB-only panel and wasted five minutes.

You can fetch again later if someone just posted a claim in Open Dental and you need a fresh copy.

Review statuses on the row

Status you might see What to do
Not fetched Tick the patient, click Fetch Open Dental, then open the row.
Pending Matching has not decided yet. Fetch if you have not; then look.
Needs review Ordo is unsure, or identity checks failed. Open Audit.
Approved Someone confirmed the claim. Ready to post (if your role allows).
Posted Ordo wrote the payment to Open Dental. You are done with this person on this file.
Already Posted Open Dental already had matching amounts on a check. Success — not a failure. Same locks as Posted.
Rejected Match was thrown away. Decide whether to try another claim or leave it.
No match No plausible Open Dental claim. Search the chart; you may need to post by hand in Open Dental.
Failed Fetch or a later step failed. Retry fetch; check API logs if it keeps failing. Do not confuse with Already Posted.

The file can stay Extracted while people on it are in different statuses. Status map with arrows (what is allowed vs off): Statuses.

Tab 1 — EOB Review

This is “what the insurance company wrote,” as Ordo read it.

You will see the extracted patient, their claims, and procedure lines: CDT codes, dates, plan covered amounts.

If your role includes Edit extracted data, you can correct a misspelled name or a wrong amount before matching. Fix the EOB side here when the PDF was read slightly wrong. Do not “fix” Open Dental by editing this tab — Open Dental is the next tab.

Example. The PDF printed MARIA SANTOS but Ordo captured MARIA SANT0S (zero instead of O). Mike edits the last name on EOB Review, fetches again, and the match confidence jumps.

Tab 2 — Payment Analysis

“Did the insurer pay what our contract says?” for this patient, line by line: contracted fee, patient’s share, expected, paid, and underpayment. It loads the saved result (or runs on first open); Refresh recalculates.

This tab does not affect posting. You can post a payment that is short — then flag it here with Review so someone follows up with the payer.

If a line shows NA, Ordo is missing a contracted fee or the EOB’s patient amounts disagree. Full explanation: Payment Analysis inside an EOB.

Tab 3 — Open Dental

If the EOB name and the Open Dental name disagree (nickname, missing middle name, spelling), do not start by rewriting the EOB. Open the Open Dental tab and use Find possible patients — Ordo can search by date of birth and similar names, then you select the chart. Details: Finding the patient.

This is the posting desk for claims. Full walkthrough: Matching and remarks.

In short:

  1. Ordo lists claim candidates. The recommended one is pre-selected when it is confident.

  2. You compare procedure lines:

    Column Meaning
    EOB Plan covered amount from the remittance.
    Open Dental What Ordo will write as InsPayAmt, plus the Open Dental procedure number when matched.
    Difference Leftover when the EOB line has no matching Open Dental procedure.
    Status Match or Differs.
    Remark Editable note on that line.

  3. You Approve match (still nothing written).

  4. You Post payment (writes amounts and notes). A popup reports success or the error.
  5. Or you Reject match if it is the wrong visit.

Hard mismatch

If the candidate shows Hard mismatch, identity checks failed (patient, date of service, or procedure codes). Amounts might still add up. Do not approve until you pick a different claim or reject. Open Audit to see which check failed.

If Open Dental changed after you approved, Ordo will ask you to review again rather than overwrite quietly.

After a successful post you should see a popup, including the Open Dental claim payment number when the API returns one. Post payment is then off. Which buttons work at each status: Statuses.

Tab 4 — Audit

Two things live here:

  1. Open Dental audit — every fetch, reject remark, and post for this EOB. Copy the report when a write fails.

  2. Match audit — the “show your work” list. Each signal is one comparison:

  3. Patient ID

  4. Patient name
  5. Date of service
  6. Payer
  7. Provider
  8. Procedure codes
  9. Amount reconciliation

A failed signal reads in plain language, for example:

Patient name mismatch — EOB has MARIA SANTOS. Open Dental has MARIA SANTOS-LEE.

Use Audit when:

  • Status is Needs review
  • You see Hard mismatch
  • A post failed (use View audit on the popup, or open this tab)
  • The dollars match but your gut says it is the wrong visit (twins, same last name, two cleanings in one month)

Other buttons on this page

  • Download EOB — saves the original uploaded remittance (PDF or image), the same file as the dashboard row menu.
  • Workflow guide — which buttons work at each patient, match, and file status.
  • Posting / Payment Analysis — switch between working the patients and checking the whole file for underpayments.
  • Export — download this file’s current list view (or the open patient tab) as a spreadsheet. That is not the original PDF.
  • Summary / board panels — totals for the remittance, useful on a long file.
  • Back to dashboard — returns to the inbox. Your work is saved; you do not “lose” an approval by leaving.

Worked example (one patient)

File: Cigna_Remit_Aug24.pdf
Patient: Maria Santos
EOB: D0150 (exam) plan covered $42.00; D1110 (cleaning) plan covered $100.00
Open Dental: Claim 18421, same date of service, same two codes.

  1. Mike selects Maria, clicks Fetch Open Dental.
  2. He opens Maria. EOB Review shows $142.00 total plan covered.
  3. Open Dental tab recommends claim 18421. Both lines say Match.
  4. Audit: all signals green.
  5. Mike clicks Approve match. Toast: nothing posted yet.
  6. Jennifer (who can post) clicks Post payment.
  7. A popup appears with a claim payment number (or Already Posted if Open Dental already had matching amounts). Maria’s row says Posted or Already Posted. Post payment is off.

If step 3 had recommended last year’s claim instead, Mike would pick the June 12 claim from the candidate list — or Reject match and stop.

Afterwards, Jennifer opens the file’s Payment Analysis tab and clicks Run analysis. Both lines say On contract — Cigna paid the contracted fee.