Permissions: You must have Billing Permissions with the ability to "Submit Claims to Clearinghouse" enabled.
After a Claim is Accepted by the Payer you will receive an ERA with payment for that Claim.
NOTE: You will not typically receive the ERA Payment the same day the Claim is Accepted. It often takes time for the ERA Payment to process after the Claim is Accepted.
NOTE: When posting ERAs containing same-day aggregation lines, adjustments will be applied evenly across all originating invoice line items.
Once you receive the ERA, you will need to process that Payment. Processing payments applies the ERA payment to the Invoice and either marks it as fully paid, OR leaves the Invoice open so you can write off the balance not covered by the Payer or shift the balance to the Client's responsibility.
- Click Billing tab in primary navigation bar.
- Click Claims in side menu and then the ERA Received tab.
- Set the appropriate Date Range and/or Customize your Grid to include additional columns.
- If there is a mismatch, be sure to resolve that BEFORE you process Payments.
Process Payments One by One
- Click Actions for every Payment and select one of the following:
- Process Payment - This means you're taking the Insurance Payment and applying it to that Invoice/Claim on the Ledger. When you choose this option the Payment will automatically be applied to the Invoice/Claim. The ERA will then move to the Paid/Processed tab on the Claims screen.
- Mark as Process - No Payments are being applied to the Invoice but that Payment line moves to the Paid/Processed tab. If you accidentally marked a Payment as processed without applying, see below.
Process Multiple Payments
- Click the checkbox for all applicable Payments.
- At top, select Process Payments or Mark as Processed.
Resolve a Mismatch
Occasionally when you receive an ERA, it doesn't match back up with the original Claim you submitted. If this happens, you will want to manually resolve the mismatch before you Process Payments
- Click Resolve Match.
- Select appropriate Client.
- Select appropriate Payer.
If you accidentally marked a Payment as processed without applying, see below. it then you can reverse the movement. Go to the Paid/Processed tab > click Actions next to the Payment > choose Mark As Not Processed. The Payment will go back to the ERA Received tab for you to apply.