Posting an ERA

Posting an ERA

Improve productivity by automatically posting insurance payments and streamlining the payment posting process. Billers or providers, depending on who is managing the billing process, can automatically post insurance payments by posting ERAs.

 

An electronic remittance advice (ERA) is an electronic data interchange (EDI) version of an insurance payment explanation. Here is how to post an ERA. It provides details about providers' claims payment, and if the claims are denied, it would then contain the required explanations.


1. At the top left side of the zHealthEHR application window, you will see a small green colored circle . Click on it. All ERA's received from insurance payers through the clearinghouse are posted on this tab.



2. If you want to search specific ERAs, you need to:
a.
Enter Received From date by clicking on the box and selecting the date you want.
b.
Enter the date to - by default it will be today's date. You can change it by clicking on the box and selecting the date.



3. From the drop-down list, select the insurance company for which you are searching for ERAs.
a. Enter the
check number if you have received the insurance amount via check.
b. Enter the
ERA number emailed to you.



4. Click ' Search ' to search a specific ERA based on the received date, insurance company name, or check number or ERA number.



5. You will see a list of ERAs received from an insurance company.
To post a specific ERA, click on the
Post ERA Payments link.
If you just want to view that specific ERA, click
View/Download . The file will be downloaded and saved onto your computer.



6. When you click ' Post ERA Payments ', a detailed page opens which contains insurance payment explanations. Here are the details you will be able to see in the page:
a. Patient Name
b. Claim Number
c. Check Number



7. Next, you will find:
a. ERA Amount
b. ERA Received Date - You can edit the ERA received date
c. ERA Deposit Date - The Deposit Date will be different from the current check-date and posting date. The Deposit Date will be the date used for an invoice payment for a visit. However, y
ou can edit the ERA Deposit Date.



8. Under the Claim Status, the following are the details you can read and edit:
a.
Date of service and CPT codes used for the treatment given to the patient. You can view it. 
b. The
insurance amount paid for a given CPT code shown inside brackets.
c. Box provided where providers or billers can enter the modified amount for a given CPT code. zHealth gives you the ability to overwrite what the ERA says.
d. If you want the patient to pay a certain amount from the billed amount, you can click the '
+ ' icon.
On clicking the '
+ ' icon, you will be able to add a certain amount as the patient responsibility and enter the reason for the same (Enter a few words for the patient responsibility reason and select the right option from the drop-down list).



9. Under the Reason column, the insurance company provides the insurance adjustment reason number.
At the end of the billed amount area, you will see the adjustment reason in asterisk. You will get to know whether your billed amount is accepted, denied, or rejected by the payor here.



10. Under the ' Action ' option, select if you want to close the ERA, close w/o applying payments, rebill the payor, or put the ERA on hold.
a.
Close - Click 'Close' when you accept the ERA and want to close the claim.
b.
Close W/O Apply - Choose this option if you have received duplicate ERA for the same. Sometimes insurance payers send multiple ERAs for the same claim.
c.
Rebill - Choose this option when some of the billed amounts are rejected by the insurance company and you want to submit a claim again to the payor after making necessary changes in the invoice.
d.
On Hold - Choose 'On Hold' only if you want to put an ERA posting on hold as you are not sure about certain things mentioned in the ERA and want to clarify the same with the payor via phone call or email.



Important Notes
1. Always post insurance payments through the ERA. Do not post insurance payments directly to the invoice.

2. Choose the action “crossover” when posting ERA payments once the primary Medicare insurance is paid. Medicare will submit a claim to the secondary insurance, but making the action “crossover” creates a secondary claim in zHealth (it is not submitted, but rather there to view/map when the secondary is paid. 3. Once a payment is posted to a primary claim and a secondary claim is submitted, you are not able to edit the primary claim. Contact our customer support team.

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