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 zHealth Dashboard, 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.
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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. c. From the drop-down list, select the insurance company for which you are searching for ERAs. d. Enter the check number if you have received the insurance amount via check. e. Enter the ERA number emailed to you. f. Click "Search" to search a specific ERA based on the received date, insurance company name, or check number or ERA number. |
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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. |
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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 |
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7. Next, you will find:
a. ERA Amount
b. ERA Received Date - This will populate based on the date the ERA was downloaded from the Clearinghouse. This date can be edited before applying payment.
c. ERA Deposit Date - The date you want the funds deposited and to show as "Date Paid" on the invoice and in reports (same as Deposit Date in EOBs). This date can be edited before applying payment. |
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8. Under the Claim Status, the following are the details you can read and edit:
a. ERA Amount b. ERA Received Date c. ERA Deposit Date d. Date of service and CPT codes used for the treatment given to the patient. You can view it. e. The insurance amount paid for a given CPT code shown inside brackets. f. 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. g. 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). |
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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. |
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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. |
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Important Notes
:
1. To ensure accurate payment posting in zHealth Software, it is essential to post insurance payments from the Electronic Remittance Advice (ERA) screen or the Explanation of Benefits (EOB) screen at the Current Procedural Terminology (CPT) level. This method allows for more precise payment allocation and can help prevent errors that could potentially affect secondary claim submission.
2. After receiving the ERA/EOB from Medicare as the primary insurance, apply the payment in zHealth software at the CPT level and choose "crossover" as the action type. It is important to wait for the secondary insurance to respond. When claims are submitted by providers to Medicare as primary insurance, the claim is automatically forwarded to the secondary insurance (if COB is updated), eliminating the need for manual submission of claims to secondary insurance by providers.
1. To ensure accurate payment posting in zHealth Software, it is essential to post insurance payments from the Electronic Remittance Advice (ERA) screen or the Explanation of Benefits (EOB) screen at the Current Procedural Terminology (CPT) level. This method allows for more precise payment allocation and can help prevent errors that could potentially affect secondary claim submission.
2. After receiving the ERA/EOB from Medicare as the primary insurance, apply the payment in zHealth software at the CPT level and choose "crossover" as the action type. It is important to wait for the secondary insurance to respond. When claims are submitted by providers to Medicare as primary insurance, the claim is automatically forwarded to the secondary insurance (if COB is updated), eliminating the need for manual submission of claims to secondary insurance by providers.
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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