ERA FAQs
Archived ERAs
Claim Type
Processed as Tertiary/Patient only has a Primary Insurance
The Claim Type comes in the Electronic File from the Payer.
Even if the Claim Type is incorrect, it does not prevent the posting of the Payment.
Credit Cards
Dates
The ERAs load into the System
As soon as the Clearinghouse, Etactics, receives the ERA files, they are sent to the PM System.
The System processes them hourly on the half hour. (The job actually runs at the 26th minute.)
Reference Batch Received Date
By default, the Received Date is populated by the Paid Date on the ERA File.
If you want the Received Date to be a different Date, enable the System Setting, ERARECEIVEDATE.
ERAs/EOBs (Explanation of Benefits)
Insurance Profile
Primary forwards to a Payer not on the Patient's Insurance Profile.
Medicaid
Medicaid Secondary is dropping the balance to the Patient
Post an ERA
Secondary Payer
This most often occurs when the Primary Insurance pays $0, such as applying to the deductible.
Unbalanced Claims
Archived ERAs
How do I Archive ERAs?
Where do I find Archived ERAs?
Claim Type
Why does the ERA Claim Type say it is Processed as Tertiary when the Patient only has a Primary Insurance?
- The Claim Type comes in the Electronic File from the Payer.
- Even if the Claim Type is incorrect, it does not prevent the posting of the Payment.
Credit Cards
When will the ERA be generated if the Patient pays with a Virtual Credit Card?
- The ERA 835 File will not be generated until after the Credit Card is processed.
Dates
When do the ERAs load into the System?
- As soon as the Clearinghouse, Etactics, receives the ERA files, they are sent to the PM System.
- The System processes them hourly on the half hour. (The job actually runs at the 26th minute.)
How is the Reference Batch Received Date determined for an ERA?
- By default, the Received Date is populated by the Paid Date on the ERA File.
- If you want the Received Date to be a different Date, there is a System Setting to allow the entry of a Received Date on the Reference Batch (ERARECEIVEDDATE) (Release 4.7)
ERAs/EOBs (Explanation of Benefits)
- To see and print only one Patient's EOB without seeing the rest of the Patients on the Remit:
Hold
Insurance Profile
What should I do if the Primary forwards to a Payer that is not on the Patient's Insurance Profile?
- The Remit will not post and is assigned a Status of CM.
- Map the Insurance using the Mappings button on the ERA Remits Items screen.
Medicaid
Why is Medicaid (Secondary) dropping to a Patient Balance?
- If yes, create a rule for Medicaid in ERA Management Rules with the Procedure Code attached.
- Add Rule CO45 > Post as Remitted > Balance Management.
- This will write off the amount that is dropping to a Patient Balance.
Post an ERA
Reports
What Report can I run to see my ERA Receipts?
Secondary
This most often occurs when the Primary Insurance pays $0, such as applying to the deductible.
- The Secondary pays as the Primary.
- The Remit is statused as On Hold.
Unbalanced Claims