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Balance all Payments on an ERA, EFT or ACH

Version 14.19

Path: Billing tab > Billing Center button > ERA Payments tab

Overview

After posting an ERA, it is important to make sure that the postings balance to the ERA payment amount. This ensures that there are no posting errors and that all adjudications received for the ERA have been reviewed and posted.

Balance an Electronic Payment 

  1. Navigate to the ERA Payments tab of the Billing Center using the path above.
  2. Locate the specified Payer, then ERA Check #.
  3. Confirm the amount in the Posted Payments column matches the amount in Payment Amount column.

Tip: You can manually log that a check is fully posted by making a note in the Note field for the specific ERA. Additionally, you can apply a time and date stamp by clicking the Stamp on the ribbon and pasting in the Note field.

Review Out of Balance Payments

Posted ERA Payments are considered to be out of balance when the amount in the Posted Amount column does not match the amount in the Payment Amount column. 

Note: When an ERA is unbalanced, the entire ERA row is highlighted in yellow. This highlight indicates that the ERA has a difference that is causing the Posted Payments and the Unposted Payments to not equal the Payment Amount. An example of where you will see this is in the case of a recoup. It is recommended that yellow highlighted lines be investigated to determine what is causing the difference prior to posting any payments on that ERA.

The following steps should be taken when a posted ERA Payment is out of balance. 

  1. Navigate to the ERA Payments tab of the Billing Center using the path above.
  2. Locate the out of balance ERA Check #.
  3. Click the Ellipses button. The Transactions Paid By ERA Payment ID window is displayed with the transactions posted to the corresponding ERA.
  4. Review the postings to identify what is causing the payment to be out of balance: 
  • If a payment is out of balance because of how the Adjudications were matched, navigate to the patient chart and void the incorrect posting in the Claims window. Then, manually enter the Adjudication information as a Payment ensuring the exact same ERA Payment ID is entered as the Check/Ref #.
  • If a payment is out of balance because the payment is split between OP and a legacy billing system: 

User Permission: The following workflow includes the use of the Override out of balance indicator checkbox. This checkbox is only visible to users with the permission: Billing_Payment_Supervisor.

  1. Post the appropriate payments in the legacy system.
  2. Confirm that the total amount posted in the legacy system and the total amount posted in OP equal the amount of the payment.
  3. In the Transactions Paid By ERA Payment ID window, select the Override out of balance indicator checkbox. 

  1. Enter a reason for the override. The override and the override reason are saved in the audit log. 

Note: Once the out of balance payment has an override performed, the Posted Payment field of the ERA in the ERA Payments tab is highlighted in yellow as a visual indicator that an override was performed. The payment will also be displayed when the Override Performed radio button is selected in the Posting status section of the window.

Version 14.10
Path: Smart Toolbar > Billing button > ERA Payments tab

Overview

Follow the steps below to balance an ERA after posting.

  1. On the Smart Toolbar, click the Billing button
  2. Click the ERA Payment tab .
  3. Locate the specified Payer, then ERA Check #.

  1. If the Posted Payments do not match the Payment amount, click the Ellipses buttonto view the transactions posted to the corresponding ERA.
Note: You can manually record that a check is fully posted by making a note in the Note field for the specific ERA. Additionally, you can apply a time and date stamp by clicking Stamp on the Smart Toolbar and pasting in the Note field.


Version 14.8
Path: Smart Toolbar > Billing button > ERA Payments tab

Overview

Follow the steps below to balance an ERA after posting.

Balancing ERAs

  1. From the Smart Toolbar, click on the Billing button (to open the e-Billing center)
  2. Click on the ERA Payment tab
  3. Locate the specified Payer, then ERA/EFT/Check #
  1. Click the Ellipses (three dotted box) buttonto open a new window displaying all transactions posted against the corresponding ERA.
                   
Note: The top portion of the window will list the expected amount of the posting (as reported by the payer) and the bottom portion will list the amount your office has posted to-date. Ideally, these two amounts should match. If not, you have remaining adjudications to post against this ERA.


Note: You can manually record that a check is fully posted by typing Balanced in the Note field. This gives you the ability to clearly identify any ERA files that are or are not fully balanced/posted.