We are currently updating the OP Help Center content for the release of OP 14.19 or OP 19. OP 19 is a member of the certified OP 14 family of products (official version is 14.19.1), which you may see in your software (such as in Help > About) and in the Help Center tabs labeled 14.19. You may also notice that the version number in content and videos may not match the version of your software, and some procedural content may not match the workflow in your software. We appreciate your patience and understanding as we make these enhancements.

Post ERA Payments

Version 14.19

Overview

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

Navigating to Unposted ERA Payments

Once ERAs have been processed into OP from your clearinghouse, there are two ways to access them for posting. 

  • Navigate to Billing tab > Billing Center button > ERA Payments tab
    or
  • Click Remits in the Main Navigation Panel
Note: Clicking Remits directs you to the ERA Payments tab of the Billing Center focused on the Unposted Posting Status. You can change your Posting status from this window. 

Posting Payments

  1. Click the next to a selected Payer to expand the list of Payments.
  2. Navigate to the ERA that should be posted. You will see the Payment Amount, Posted Payments and Unposted Payments.
  3. 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 + 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. 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 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 14.10
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.