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ERAs

Learn how to apply Electronic Remittance Advices (ERAs) to patient invoices

Written by Blake Bays
Updated over a month ago

This guide explains how to apply Electronic Remittance Advices (ERAs) to patient invoices once they have been transmitted from Claim.MD.

Access the ERA module

  • Navigate to the ERA Module to view all ERAs transmitted within your selected timeframe.

  • Adjust the timeframe as needed to locate ERAs, whether or not they have already been applied.

Review Available ERAs

  • For ERAs not yet applied to an invoice, you will see Apply and Ignore options on the right.

  • You can also:

    • View the ERA PDF.

    • Save the ERA to the patient's E-Documents section.

Apply an ERA

  • Select Apply for the ERA you want to process.

  • The Apply Claim Remittance modal window will open.

1. Verify Claim Remittance Information

  • Confirm the following details are accurate:

    • Patient Name

    • Claim Payer

    • Paid Date

    • Service Date

    • Additional claim information

2. Review Charges and Adjustments

  • The Charges section shows:

    • Amount charged

    • Amount paid

    • Adjustments

  • You will also see:

    • Procedure Code

    • Adjustment Type

    • Group (e.g. PR for Patient Responsibility, CO for Contractural Obligation)

      • Note: Contractural Obligations (CO) are automatically marked to be applied.

    • Code

    • Apply checkbox for adjustments

3. Apply Patient Responsibility

  • Patient Responsibility is not applied automatically.

  • Use the Transfer Outstanding Balance to Patient Responsibility option to apply it.

  • Applying each adjustment will reduce the patient's required balance accordingly.

4. Check the Summary Section

This section provides totals for:

  • Charges

  • Payments

  • Adjustments

  • Unapplied adjustments

5. Review Invoice Summary

  • The invoice summary displays:

    • Responsibility

    • Balance

    • Balance after ERA application

  • You may change the invoice by selecting Change Invoice if needed.

6. Configure Payment Application Options

  • Optional settings:

    • Transfer Outstanding Balance to Patient Responsibility (toggle on/of)

    • Post Payment/Adjustment Per Line Item (toggle off to post totals instead)

7. Apply the ERA

  • Once all settings are verified, select Apply to post payments and adjustments to the chosen invoice.

Related Articles
Creating a New Invoice
Insurance Payments and Adjustments
Creating and Applying Credits
Patient Adjustments
Patient Multi-Invoice Payment
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