ERA 835, also known as electronic remittance advice format, is an electronic explanation of benefits (EOB) that can be automatically downloaded.

In the Manage Module, click ERAs.

Automatically or manually download ERAs then use the ERAs to auto-populate insurance paid amounts by claim and quickly receive claims and finalize insurance payments.

Webinar: ERA 835

Set up Requirements

To start using, sign up for ERAs with a clearinghouse. Automatic download of ERAs are supported through ClaimConnect E-Claims, Denti-Cal, Change Healthcare Medical/Emdeon Medical, and Electronic Dental Services. Not all insurance carriers or clearinghouses offer ERAs, or the ability to automatically download. If automatic downloads are not available, manually download ERAs to the Claim Report Path in the Clearinghouse set up.

Note: User must have permission for Insurance Payment Create to access ERAs.

ERA Troubleshooting

Managing ERAs

ERAs can also be viewed and processed via the Insurance Claims window, History grid. See Send Claims. By default, ERAs received in the last 7 days that have a status of unprocessed, partial, or not finalized will list. Claims will be matched with an ERA and if one is not found, you will be prompted to find the correct claim (see, ERA Match with Claim). If more than one patient is associated with an ERA, the number of claims on the ERA shows in the Patient Name column instead of a name. Double-click on a claim to Process and view EOB Claim Details.

If a claim on the ERA list has special circumstances, add the claim to the Outstanding Insurance Claims Report and set a tracking status. See, Track ERA.

Use the filter options to change the ERAs listed in the ERAs grid. Click refresh after each change.
From/To: Change the date range. Click the down arrow to select dates from a calendar then click the up arrow to collapse the calendar. Click the W buttons to jump back or forward one week.
Amount Range: Only show ERAs within a certain payment amount range. Min = the minimum payment amount to show. Max = the maximum payment amount to show. Leave blank to show all ERAs regardless of payment amount.
Control ID: Filter by Control ID. Option must be enabled in Show Features.
Carrier: Filter by carrier.
Check# or EFT Trace#: Only show ERAs for a specific check number or EFT trace number.
Clinic: Filter by clinic. If an ERA has more than one clinic, multiple will list in grid.
Status: Filter by ERA processing status.

Code types are used to determine payment methods. The following codes are used: