Jane's Guide Here's all the help you need to use Jane.

Posting Insurer Payments With Electronic Remittances (ERAs)

Short on time? Click on this icon in the bottom right-hand corner to skim through the video chapters!


Show me the money! In this guide, we’ll walk through how you can post insurer payments using our ERA Management Tool by uploading electronic remittances (ERAs) to Jane. If you still have questions, you can visit our fully-loaded FAQ guide that we’re continuing to grow as well.

To kick off the payment posting process, the first thing you’ll need is the ERA. You’ll be able to find and download ERAs from your clearinghouse, although how and where you download ERAs is different for each clearinghouse.

Click the links below for some guidance on how to download ERAs from our most commonly used clearinghouses:

Pro Tip: PDFs, ZIPs, and Spreadsheet files (i.e., CSVs) cannot be processed as electronic remittances. Your clearinghouse should have an option to download ERAs in one of the following formats: 835, x12, txt, or dat.

Once you’ve downloaded an ERA from your clearinghouse, head to the Billing tab in the top blue bar of your Jane account, scroll down to the Claim Responses area, and click the Remittances folder.

To upload an ERA, we can either drag and drop the file or press the Upload button in the top righthand corner.

Jane needs a few seconds to read and process the file. It’s usually pretty fast, but sometimes Jane needs a little more time depending on the size of the ERA.

When Jane is done processing the file, you’ll see a new remittance in your list.

Pro Tip: If you’re paying really close attention, you’ll notice that your Response Received folder grew after you uploaded your ERA. That’s because Jane linked all the claim responses in the ERA to claims in your account, and automatically moved those claims from the Submitted folder to the Response Received folder. The Response Received folder contains all the claims on your account that have been linked to a claim response, but that still requires a review!

At a glance, you can see which insurer sent the remittance, how many claim responses are included, and how much money you’re receiving for those claims. You can also see that your new ERA is Awaiting Review. This means that you need to take a look at the remittance - which can be done by clicking the View button.

When reviewing a remittance, there are *two steps you’ll need to complete to post the insurer payment.

Step 1 is simply recording the insurer payment. Jane pre-fills all the payment info from the details in the ERA, so all you’ll need to do is press the record payment button.

Once you’ve recorded the payment, it’s time to move on to Step 2: reviewing each of the claim responses in the remittance.

In Step 2, you are presented with a list of important information for each claim response in the remittance, like how much you were paid and the patient responsibility.

To review your first claim response, just click the View button.

This brings us to the Claim Response view - which has two main sections.

  1. ERA Details
  2. EOB Screen

The first section, ERA Details, includes adjudication info pulled directly from the remittance for each procedure that was billed. You can think of this as Jane’s version of a paper EOB.

The second section, EOB Screen, is just the same old EOB screen that you’ll also see when recording paper remittances. This is the section where you tell Jane how much insurer payment to apply, and how to adjust the patient and insurer invoices.

When working with ERAs (opposed to paper remittances), Jane pre-fills the EOB screen with all the info from the remittance– info that you can see displayed in the first section. That means there is no need for manual entry!!

If all the amounts the insurer sent look good to you (no follow-up or re-billing required), simply post the EOB by clicking the Apply Changes button. This applies the payment to the insurer invoice and updates the invoice for the patient or next payer.

Applying changes also moves the claim response from Awaiting Review to Reviewed. You’ve let Jane know that you’ve taken a look at the claim response, and you’ve crossed it off your to-do list.

Once your first claim response is Reviewed, the entire Remittance will move from Awaiting Review to In Progress. You can also see the status of the remittance (how many claim responses you’ve reviewed) at the top of the screen at any point to check on your progress.

To finish up with our remittance, we just need to repeat the review process for all claim responses. Once they’ve all been reviewed, then you’re done!

If we head back to our Remittances to-do list, we’ll no longer see this remittance by default since it’s been fully Reviewed. Only remittances that still require your attention will show in this list by default. That said, if we ever need to take another look at it, all we need to do is change our filters.

 

And as always, let us know your thoughts! You can email our support team at [email protected] or join the conversation in our community group on Facebook! We love hearing from you.


 

How do I download ERAs from Claim.MD?

Select View ERA which can be found under the Claim Menu. Next, select all the ERAs you haven’t processed yet (you can select multiple in one go!). The last step is to click the Select Action dropdown, and choose the Download Selected 835 option.

 

How do I download ERAs from Office Ally?

For full instructions on how to download ERAs, check out Office Ally’s User Manual - Page 15

  1. Click on Download EOB/ERA 835.
  2. Select a date on the calendar. Pink dates are days that have pending ERAs.
  3. Click the View link in the Download/View column next to the ERA file you wish to download. This will download the zip file which contains both the actual 835 file and a readable text version (txt) of the ERA.

You’ll need to upload the 835 file to Jane. Jane can’t process the readable text version!

How do I download ERAs from Availity?

Head into your Claims & Payments folder, and select the Remittance Viewer. You’ll be able to download remittances on the next screen!

 

How do I download ERAs from TriZetto?

You can download new remittances in a folder in your account called Remits.