Understanding ERAs

electronic remittance advice (era), also known as an 835 file, is the electronic explanation of payment you receive from an insurance payer after a claim has been processed where to find eras 1 go to billing 2 click remittances you’ll see a list of all received eras you can filter by all received posted failed each era shows era id payer mode (auto or manual) date received number of claims total payment status understanding era status each remittance has a lifecycle received – the era has been received from the payer reviewed – (if applicable) the era has been reviewed posted – payments from the era have been applied to claims if the status is posted , the claims inside that era have already been updated with the insurance payment opening an era click on an era id to view its details at the top of the era page, you’ll see total charged insurance paid adjustments net rate number of claims status this gives you a quick financial summary of the remittance era information section this section includes era identifier external transaction id check number (or eft trace number) insurance payer payment method (e g , ach) posting mode (auto or manual) this helps you match the era to bank deposits or payer records era lifecycle this timeline shows when the era was received when it was posted this allows you to track when payments were applied to claims financial summary the financial summary includes total charged total paid variance net payment rate this provides a high level overview of how the payer processed the included claims claims inside the era each era contains one or more claims for each claim, you can view patient name internal claim number payer claim number service date charged amount paid amount adjustments patient responsibility claim status if the era is posted , the payment has already been applied to the claim raw 835 data you can expand the raw 835 data section to view the original remittance data received from the clearinghouse this includes claim details service line information paid amounts procedure codes control numbers this section is useful for advanced review or reconciliation downloading the era from the era page, you can download the era pdf copy the era id this can help with accounting or payer follow up what happens after an era is posted? when an era is posted insurance payments are applied to the associated claims claim status updates accordingly patient responsibility amounts are reflected in billing if a claim was partially paid or adjusted, you can review the details within the claim record