Version 14.19

Path: Billing tab > Billing Center button > Adjudications tab

Overview

Before posting ERA (Electronic Remittance Advice) payments, the ERA files (835) are retrieved from supported clearinghouses, or those clearinghouses with which OP has vendor relations using a process called Fetch and Process. The Fetch and Process workflow is described below. Once the ERA files are processed into OP, the adjudications contained in each payment are displayed in the Adjudications tab, and the payment itself is displayed in the ERA Payments tab.

Fetch and Process

1. Navigate to the Adjudications tab of the Billing Center by following the path above.

1. Click the Fetch Files button. This step fetches/retrieves pending ERA (835) files from your supported clearinghouse.

1. Click the Process button. This steps reads fetched ERA (835) files into OP. Adjudications are displayed on either the Matched or Unmatched tab of this screen depending on whether OP was able to identify the matching claim to the adjudication as presented on the ERA (835) file.

Version 14.10

Path: Smart Toolbar > Billing button > Adjudications tab

Overview

ERA (835) files can be automatically retrieved from supported clearinghouses, those clearinghouses with which OP has vendor relations. For those offices contracted for e-billing that do not have a supported clearinghouse, you can still manually retrieve (fetch) and process ERA files. The step of Fetch first does not need to be done if a practice is using the cloud model.

Fetch and Process

1. Click the Billing button on the main OP screen (to open the e-Billing center).
2. Click the Adjudications tab.
3. Click the Fetch button.

Note: This process fetches/retrieves pending ERA (835) files from your supported clearinghouse. If you are unable to automatically fetch your files because your office is contracted with a non-supported clearinghouse, you can manually download an ERA file from your clearinghouse or a payer website and save it to your Claimnet folder on your GBD_Common server. Once the files are saved in the claimnet folder, proceed to the next step.

If your office is on a Cloud Model of Office Practicum, you cannot manually download .835 files to your claimnet folder.

1. Click the Process button.

This process reads fetched ERA (835) files into OP. Adjudications are displayed on either the Matched or UnMatched tab of this screen dependent on whether OP was able to identify the matching claim to the adjudication as presented on the ERA (835) file.

The ERA files are downloaded.