Using the Job Scheduler provides the option to auto-apply ERAs using a set of Criteria. Mutliple Jobs can be created to meet your needs. The Job Criteria determines how the ERA is posted, such as:
Apply by Paid Date
By ERA ID
Specified order to post
Split ERAs into different Reference Batches based on the selected options.
Before using this feature:
Your team needs to have a good grasp on manually applying ERAs in the System.
Determine the workflow for handling the following since these items need manual review:
DW - Denial Worklist
CW - Custom Worklist
H- Holds
Escrow
Contact your Administrator or Trainer for more information on setting up ERA Management Rules and Setting up the Job Scheduler.
From Admin on the Left Side Menu, select the Job Scheduler button.
Select the Add button.
Run Function: Select Apply ERAs.
Criteria
Close Reference Batch: When the ERA Job runs, it will create Reference Batches to organize the work. ERAs will be placed into one or more Reference Batches based on the One Reference Batch per option chosen in the next selection. The following options determine if the Reference Batches should be auto-closed.
No: Always leave the Reference Batches open.
Yes - All: Always close the Reference Batches.
Yes - Only fully Adjudicated: Only close the Reference Batches when there are no Remits on Hold for all ERAs in the Reference Batch.
Yes - Only fully Applied: Only Close the Reference Batches when the Check Amount = the Applied Payment Amount for all ERAs in the Reference Batch.
One Reference Batch per:
Select how the ERAs are to be batched.
Job: The One Reference Batch per Job selection will put all ERAs applied by this Job into one auto-created Reference Batch.
Tax ID: If the Practice has more than one Tax ID, the ERAs will have a Reference Batch per Tax ID.
Payer ID: The ERAs will be batched by the Payer ID; not necessarily by the Payer because a Payer may have more than one Payer ID.
Example: CIGNA has several Payer IDs because they are the administrator of other plans. Each Payer ID would be in a separate Reference Batch.
Insurance ID: The ERAs batch by the Insurance ID that you have set up in the System; one Reference Batch per Insurance ID.
If you receive 3 Medicare ERAs today whose Insurance ID is MCR, all 3 will post in the same Reference Batch.
ERA ID: The ERAs are batched by the ERA ID number; one Reference Batch for each ERA.
ERA Payer ID; This number may or may not be the same as the Payer ID, but like the Payer ID there could be more than one ERA Payer ID.
Check ID: The ERAs will be batched by the Check number; one Reference Batch per check number.
EFT: The ERAs are batched by the type of Payment, EFT (Electronically deposited); one Reference Batch for all unposted EFTs. Payments that you receive by check will not be included.
Paid Date: All unposted ERAs with the same Paid Date will be batched in one Reference Batch.
You may receive 5 ERAs today, but that does not necessarily mean that they have the same Paid Date.
Loaded Date: All unposted ERAs with the same Load Date will be batched in one Reference Batch.
If 10 ERAs were loaded into the System today, all 10 will be in one Reference Batch.
Apply ERAs by: This setting determines the order that ERAs are applied
ERA ID: Applies ERAs by the oldest ERA ID first.
Paid Date: Applies ERAs by the oldest Paid Date first
Criteria Add
Enter a Description
Apply All Loaded ERAs: If this option is selected, all ERAs in a Loaded status will be applied when the Job runs.
Deselect this option to use the other Filters.
Select the filters to use for running the Job.
Select Add to Job [F2].
In the Example below, the job is setup to run Medicare ERAs only.
Pattern: Choose when you want the Job to run and how often.
Range: Choose a Start Date and Time and select No End Date.
Click Save [F2].
The person(s) responsible for the ERA review will attach to the Reference batch(es) generated by the Jobs.
Use the Filters on the ERA List screen for the Reference Batch being worked.
Review all applied ERAs for DW - Denial Worklist, CW - Custom Worklist and H- Holds
Use the yellow highlighted amounts to identify issues such as provider level adjustments.