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We are currently updating the OP Help Center content for the release of OP 20. OP 20 (official version 20.0.x) is the certified, 2015 Edition, version of the Office Practicum software. This is displayed in your software (Help tab > About) and in the Help Center tab labeled Version 20.0. We appreciate your patience as we continue to update all of our content.

Post ERA Payments

Version 14.19
Path: Billing tab > Billing Center button > ERA Payments tab > Unposted radio button
Path: Main Navigation Panel > Remits

Overview

After Adjudications have been processed into OP using the Fetch and Process workflow, the user is ready to post ERA payments. This payment posting is completed from the ERA Payments tab of the Billing Center. This tab may be filtered by Posting Status to display: All, Unposted, or Out of Balance payments. It is recommended to select the Unposted radio button to display the payments that have not yet been completely posted. The grouping of the grid may also be modified, but it is most common to group the payments by Payer Name. The workflow below assumes the grid is grouped by Payer Name.

Post ERA Payments

  1. Navigate to the Unposted ERA payments by following one of the paths above.
  2. Click the next to a selected Payer to expand the list of ERA payments.
  3. Navigate to the ERA that should be posted. The Payment Amount, Posted Payments and Unposted Payments are displayed.

  1. Click the hyperlink in the Unposted Payments column. The Adjudications tab opens with the adjudications for that ERA populated.

Note: You will notice above that the unbalanced ERA 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.

  1. Click the + to expand each adjudication and view the adjudication details. 
  2. After reviewing the details of each adjudication and editing the Match Status, if necessary, select the Aprvd (approved) checkbox (if not already selected). All adjudications with the Aprvd checkbox selected will be posted once Post Paymt is clicked.
  3. Click the Post Paymt button.
  4. Click the Yes button in the confirmation window. 


Tip: The default Match Status and Auto-Approval may be edited to streamline your ERA posting. It is recommended to take note of the defaults that are already in place before making any changes. When ready to do so, the following may be changed:

  • Match Status: The default Match Status for the Insurance Adjustment Reason may be edited in the HIPAA Code table (Billing tab > More button (Reference Data group) > HIPAA Codes).
  • Auto-Approval for Matched Adjudications: The auto-approval of Matched Adjudications can be enabled or disabled in System Preferences (Admin tab > Global Preferences > Billing tab).


Version 14.10
Path: Smart Toolbar > Billing button > Adjudications tab

Overview

The steps below assume the user has already gone through the steps of downloading ERAs. If this process has not been completed see Fetch and Process ERA Files from my Integrated Clearinghouse.

Posting Payments

  1. Click the ERA Payments tab .
  2. Click the Expand button  next to selected Payer.
  3. Navigate to the ERA that should be posted. You will see the Payment Amount, Posted Payments and Unposted Payments.
  4. Click the Blue Link in the Unposted Payments column. The Adjudications tab is displayed with the adjudications for that ERA populated.

Note: You will notice above that the unbalanced ERA is highlighted in yellow. This highlight indicates that the particular ERA has a difference that is causing the Posted Payments and the Unposted Payments to not equal the Payment Amount for that ERA. 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.
  1. Click the Expand buttonto expand the adjudication and view the adjudication details. 

  1. After reviewing the details of each adjudication and editing the Match Status, if necessary, select the Aprvd (approved) checkbox. All adjudications with the Aprvd checkbox selected are posted once Post Paymt is clicked.

  1. Click the Post Payment button .
  2. Click the Yes button in the Confirmation pop-up box.

To double check payments posted see Balance all payments on an ERA, EFT or ACH.

OP posts auto-approved adjudications based on your system setup for auto-approval of matched and/or paid claim adjudications.


The default Match Status for each Insurance Adjustment Reason may be edited in the HIPAA Code table. Click here to learn how to make those edits.
Version 14.8
Path: Smart Toolbar > Billing button > Adjudications tab

Overview

The steps below assume the user has already gone through the steps of downloading ERAs. If this process has not been completed see Fetch and Process ERA Files from my Integrated Clearinghouse.

Posting Payments

  1. Click the ERA Payments tab .
  2. Click the Expand button  next to selected Payer.
  3. Click the Ellipsis button  to select a Check.
  4. Select the OK button in the pop-up box.

  1. Copy the Check Number.

  1. Click the Adjudication tab.
  2. Paste the Check Number in the Payment ID field.
  3. Filter to Check.
  4. Click the Expand buttonto expand the adjudication and view the adjudication details. 

  1. If the Allowed Amount is correct and the payment looks appropriate for services rendered, select the Aprvd checkbox to confirm that  this adjudication is approved to be Matched.

  1. Click the Post Paymt button .
  2. Click the Yes button in the Confirmation pop-up box.

To double check payments posted see Balance all payments on an ERA, EFT or ACH.

OP posts auto-approved adjudications based on your system setup for auto-approval of matched and/or paid claim adjudications.