Post ERA Payments

Version 20.12
Path: Billing tab > Billing Center button > ERA Payments tab > Unposted radio button
Path: Main Navigation Panel > Remits

Overview

After you've fetched and processed Adjudications into OP, you're ready to post ERA payments. ERA payment posting is completed from the ERA Payments tab of the Billing Center, which can be filtered by Posting Status: All, Unposted, Out of Balance, or Override Performed. Filtering by Unposted and sorting the grid by Payer Name is the most common window setup for ERA posting, so the workflow below assumes your window is set up in this way.

Post ERA Payments

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

NoteThe yellow highlighted ERA in the image above 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 hyperlink in the Unposted Payments column. The Adjudications tab opens with the adjudications (or transactions) for that ERA populated.
  2. Click + to expand each adjudication line and review the adjudication details, including the Patient Action.
  3. 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 (in the following step).

Note: Individual transactions whose Aprvd checkbox is highlighted in yellow indicate that posting the transaction will cause the claim line to be out of balance. These transactions cannot be approved with a Match Status of Matched. By default, the Match Status is set to Discard. Transactions identified in yellow must be manually posted to the claim.

If you attempt to change the Match Status from Discard to Matched, you will receive the following message. You must return the Matched Status to Discard before being able to approve the transaction for posting.

  1. Click the Post Paymt button.
  2. 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 20.11
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: All, Unposted, Out of Balance, or Override Performed. 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).