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🇺🇸 What's an ERA in Insurance Billing?

ERA Meaning in Insurance Billing

Ah, yes. We thought you’d never ask! 😉 Ahem… an ERA is an Electronic Remittance Advice. It’s a bit of a mouthful so we’ll refer to it as an ERA or remittance for simplicity’s sake moving forward. In the form of an 835 transaction, a remittance is basically one big text file that different systems, like Jane, can process.

The remittance provides details about insurers/payers’ claim payments… important details like the Paid Amounts and Patient Responsibility, or why a claim may be denied with an explanation.

How do remittances fit into the claim submission process?

When you submit a batch of claims to your clearinghouse, the clearinghouse forwards those claims to the respective insurers/payers. When the claim is received, the insurer will process it in a (hopefully) timely manner. During this process, the insurer determines what they’ll pay, what the patient should pay, and what amounts should remain unpaid. Insurers usually do this for many claims at once, and then send all of that data back to your clearinghouse in the form of an ERA.

What’s new with ERAs?

Previously, when a new ERA was available in your clearinghouse, you would have to pop in, download that remittance & upload it into Jane. With Jane’s new integration that allows Integrated Claims with Claim.MD, you won’t have to do this anymore! 🎉 

Once Claim.MD receives an ERA, it will automatically be sent to your Jane Remittances folder where you can then use Jane’s ERA Management Tool to quickly & easily record payment.

If you choose not to enable this, you can download ERAs from your clearinghouse and then upload them to your Remittances folder. Once you’ve uploaded an ERA, you can post the payment using the ERA Management Tool.

Pro Tip: It isn’t always easy to tell the difference between electronic remittance and paper remittance options. PDFs, ZIPs, and Spreadsheet files (i.e., CSVs) cannot be processed as electronic remittances. Your clearinghouse should have the option to download ERAs in one of the following formats: 835, x12, txt, or dat.

Regardless of the method you choose, the ability to upload ERAs eliminates a lot of the manual entry work involved in posting payments from paper remittances, freeing up your time for other priorities at the clinic.

Electronic Remittance Management in 5 Steps

Here’s a simple step-by-step process we put together for our visual learners. We hope it’s helpful!

Use the arrows on the image to scroll back and forth through the steps!

So, what’s the value of the ERA Management Tool? Is it really just a way to upload an electronic file into Jane? Yes, and well, it was a critical step to remove manual entry from the original process.

Here’s how we sped up the process:

Jane queues up the insurance payment.No more searching for EFT and Check numbers.

Jane links all ERA claim responses to those in your account.Say goodbye to the invoice search bar.

Jane displays the key remittance details right in front of you - both for the overall payment and for each claim response.See everything you need to in Jane. No paper EOBs and no need for a second tab.

Jane pre-fills the EOB screen with the info from the claim response.No more manual entry.

A quick clip of us dragging and dropping an ERA from our desktop into the new Remittances screen. There is also an option to upload.

Additional Resources

To learn how to use Jane’s ERA Management Tool, you can take a look at the following guides:

🎬 For a more in-depth look at this tool, you can watch our recorded webinar from our Allied 2021 Summer School, ‘A New ERA: US Insurance Billing Features in Jane’.

If you have any questions, we always love hearing from you. You can email our support team at [email protected].

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