Electronic Remittance Advice (ERA)

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Electronic remittance advice (ERA) is a digital version of the paper explanation of benefits (EOB) you may receive from payers via mail. Unlike EOBs, however, ERAs are routed directly into your TherapyNotes account, allowing you to maintain your billing records in one secure, centralized location.

An ERA provides details about the payment you receive from a payer for the corresponding claim(s). This may include information about your contracted rate with the payer if you're in-network or the amount paid if you're out-of-network; copay, coinsurance, deductibles; and any other payment adjustments such as interest, penalties, and balance forwarding. A payer may also communicate claim rejections and refunds through an ERA.

TherapyNotes charges just $0.14 per ERA, less than the cost of a stamp. In order to receive ERAs in TherapyNotes, you must enroll with each payer you wish to receive ERAs from. Most payers require additional paperwork in order to enroll to receive ERAs. For more information, read Electronic Remittance Advice (ERA) Enrollment.

Receiving ERAs is a straightforward process and allows for a shorter turnaround on claims. If you are enrolled to receive ERAs from a payer, that payer will send an ERA to our clearinghouse, Change Healthcare, whenever they receive and process an insurance claim. Afterwards, Change Healthcare routes the ERA directly into your account. Once the ERA is received, our assisted ERA payment posting will help you process the ERA and record the payment. To learn more about how to post ERA payments, read How To: Post ERA Payments.

Role Required: Practice Biller

In order to receive ERAs, you must have TherapyNotes' electronic billing features enabled for your practice.

To enable electronic billing, EDI claims, and ERAs:

Note: Both Practice Billers and Practice Administrators can complete this step.

  • Click the User Icon > Settings > Practice Billing
  • Select the Enable Billing Features checkbox
  • Select the Enable TherapyNotes EDI checkbox

For more information about setting up your account for billing in TherapyNotes, read Quick Start: Billing.

Understanding the ERA

To view the ERAs you have received from payers:

  • Click Billing > ERA OR Click To-Do > Process ERAs
Quick Tip: The bubble next to the ERA link throughout TherapyNotes (such as on the main Billing page and on your To-Do list) will display the number of ERAs that are ready to be processed.
  • In the section labeled ERA, TherapyNotes will show all ERAs from the last 30 days that have not yet been processed by default. To expand your search or to locate a specific ERA, edit the optional search filters in the section labeled Search ERA and click the Search ERA button

View the status of the ERAs you have received using the Status column. ERAs that have already been processed will have a link to View Payment, while unprocessed ERAs will have a bold link to Post Payment. To view an ERA, click the corresponding ERA #.

The ERA viewer conveniently displays the most useful information about the payment while hiding extraneous details.

eraheader.png

The header of the ERA features the ERA number and status. Whenever you are ready to post an unprocessed ERA, click the Post Payment button in the header to process the ERA using our ERA Payment Poster. Alternatively, click the Mark as Processed button to process the ERA without recording the payment in your account.

erainfo.png

Located below the header is information about the insurance payment including the payer, payment amount, check number or transaction ID, and the date and time the ERA was received.

To view additional ERA information, claim details, and remarks, click the Show Additional ERA Information or Show Details and Remarks for All Claims links. To maintain a focus on the information that is most crucial for understanding the payment, the ERA viewer hides these details by default.

eraclaimdetails.png

Important details about the ERA payment are located below the blue divider and broken down per claim. Each claim on the ERA includes information about the service plus charged rate, patient amount, claim-level adjustments, and amount paid by the payer for that service.

(A) Charged Rate: This value reflects how much you charged for the service. The Charged Rate is equal to the Insurance Rate of the billing line item in TherapyNotes.

(B) Patient Amount: The Patient Amount reflects how much of the Charged Rate the client is responsible for, according to the payer. This may include copay, coinsurance, deductibles, and the client responsibility for out-of-network claims.

(C) Adjustments Amount: The Adjustments Amount reflects the total value of claim-level adjustments such as penalties or interest.

(D) Paid Amount: This is the amount the payer paid for this service. Generally, the Paid Amount for each line item is calculated by the Charged Rate less Patient Amount and Adjustments Amount.

(E) Patient and Adjustments Amount Breakdown: This grey box shows the breakdown of the values that constitute the Patient Amount and Adjustments Amount per service.

In addition to the above values, the ERA indicates how the payer handled each claim in the upper right corner of each of the claim breakdowns. This will read Processed as Primary if the payer is the client's primary insurance. If the client has secondary insurance and the ERA was forwarded to the client's secondary payer, this line will also say Forwarded to Additional Payer(s)

eratotals.png

The final section of the ERA lists the total amounts for all claims in the ERA, including the total amount the payer has paid.

Quick Tip: Occasionally, you may need to manually enter insurance payments using the information on the ERA. To facilitate this process, the details necessary for manually entering insurance payments (the Paid Amount per line item, Non-Claim Adjustment Amount, and the ERA Total Paid Amount) are in bold. For more information, read How To: Enter Insurance Payments.
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Comments

  • Avatar
    Christina Peterson

    I still don't know what an ERA is

  • Avatar
    Jordan

    An (ERA) electronic remittance advice is an electronic version of a payment explanation (EOB-Explanation of Benefits) which provides details about providers' claims payment, and if the claims are denied, it would then contain the required explanations.

  • Avatar
    Tiffany Pietrowski

    Tricare is asking for clearinghouse information to setup ERA, where do I find this? Such as clearinghouse name, telephone and email address?

  • Avatar
    Jordan

    Tiffany,

    Go to "payers" click on "+Add a payer", enter in the provider name as well as the other information that is asked. Once entered, at the bottom you can click on "begin enrollment", and we will send you the information to begin the era enrollment. If you have any questions, please contact support at 215-658-4550 or via email at support@therapynotes.com

  • Avatar
    Mark Kemink
    What does it mean to "process" the ERA? Does that just mean that you've read it?
  • Avatar
    Laura
    Mark, To "process" and ERA means that you have: - Read the ERA - Entered the insurance payment into TherapyNotes If you have any other questions please let us know.
  • Avatar
    Mark Kemink
    How do I enter the payment into Therapynotes and where?
  • Avatar
    Laura
    Mark, Either click: - Billing > Enter Insurance Payment - Patient's Chart > Patient Billing > Enter Insurance Payment To learn more about entering insurance payments, see this article: Entering Insurance Payments: https://support.therapynotes.com/hc/en-us/articles/200259935-Entering-Insurance-Payments
  • Avatar
    Marya McNorton
    So in beta, since it doesn't automatically post payments, what is the advantage to using ERAs? Do they replace EOBs (e.g., eliminate the need to go to a payer's site to download EOBs)? Do they contain all the same information?
  • Avatar
    Laura
    Elaine, You are correct. At the moment, the advantage of ERA's through TherapyNotes is that they replace explanation of benefits (EOB) either via paper or going online to a payer's site. Yes, they do include all of the same information. Another advantage to getting ERA's set up through TherapyNotes now is that you will be ready to take full advantage of the auto-posting feature as soon as it is implemented. Also, ERA's are free until the auto-posting feature comes out.
  • Avatar
    Debra Epps
    What is the status and timeline when auto-posting comes out? And what will be the costs?
  • Avatar
    Laura
    Debra, On Sunday 1/24/16 we released major updated to billing that are the pre-cursor to auto-posting of the ERAs. We expect to release the auto-posting ERA feature in the next three months. When it is released ERAs will cost $0.14 each.
  • Avatar
    Leslie McLaughlin

    Is that $0.14 per claim on the ERA or for each ERA with however many claims are on the ERA?

  • Avatar
    Laura

    Leslie,

    It will be $0.14 per claim within an individual ERA.

  • Avatar
    Jane Houghtaling Walker, PhD

    Could you please advise when you expect auto-posting to come online?

  • Avatar
    Laura

    Jane,

    Assisted ERA payment posting will be released within about 2 months.

  • Avatar
    Samanthia Zolnoski

    How do we Opt out of ERA's? As it is in BETA I am unable to check the box in the Payer set up. When this feature goes live I do not want to be changed.

  • Avatar
    Laura

    Samantha,

    In order to opt out of ERA's that you are already enrolled for, please contact each payer directly and ask to switch back to paper explanation of benefits.

  • Avatar
    Regina Moore

    Our office did not enroll for ERA for a specific insurance carrier. Since we did not enroll, why did it automatically enroll us? Please change this.

  • Avatar
    Laura

    Regina,

    When adding a payer that supports ERA's, TherapyNotes automatically checks the box that designates to start the ERA enrollment process. Typically, the user has to fill out and submit the enrollment paperwork to complete the enrollment process. However, some payers do not require the additional paperwork. If you are receiving ERAs and do not recall filling out paperwork to receive them, it is likely that whoever added the payer did not uncheck the box to begin the ERA enrollment process when initially adding the payer. If you wish to turn off ERAs, please contact that payer's EDI department directly. If you would like further assistance with this issue you can contact our support team at 215-658-4550. Thank you.

  • Avatar
    Nell Bennett

    I need to print out previously posted ERA's to submit w/ my paper CMS1500's for secondary insurances claims that did not automatically forward from Medicare. Where can I find previously reviewed ERA's? Nothing is showing when I go to ERA's section.

  • Avatar
    Sean Behan

    Hi Nell,

    Please click BILLING > ERA and set the view dropdown to "All" or "Processed" and be sure that the date range includes the dates of the ERAs you are looking for.
    Please let us know if you have any other questions. Thank you.

  • Avatar
    Julie Davies

    How do I connect Therapy Notes to my bank account to process payment from an ERA?

  • Avatar
    Jordan

    Julie,

    To set up direct deposit (EFT) for funds deposit please contact the insurance company directly. If you require any further assistance please contact support at 215-658-4550 or via email at support@therapynotes.com

  • Avatar
    Melissa Perkins

    Please help! My claims are being denied when I process EDI claims to Medicaid for my therapists. It is saying prior authorization required and they are being denied; however prior authorization has been approved. I am an LPC and my claims are being paid but when I am billing for my LMFT or LCSW they are being denied thru therapy notes. WHat am I doing wrong? THanks!

  • Avatar
    Jordan

    Melissa,

    I will reach out to you in regards to your comment regarding claims being rejected. Thank you.

  • Avatar
    Heather Langan

    Hello,
    I'm wondering if I enroll to receive ERAs through TN if I can still look up claims in Blue e the same I've been doing. I find Blue e hard to navigate but since I've not yet migrated all my info over to TN, I want to make 100% sure everything works before taking that final step. Thank you.

  • Avatar
    Jordan

    Heather,

    If you enroll in ERA's you will still be able to access claims history in Blue-E. However once you start submitting claims in TherapyNotes you can view claims that were submitted within your account by clicking on billing> edi claim history. This will show the claims you submitted from TherapyNotes along with any communication from the payer and clearinghouse. If you have any questions please contact support@therapynotes.com or via the phone at 215-658-4550.

  • Avatar
    Admin A

    What is the difference between the two ERA payment options, "Mark as Processed," and "Post Payment?"

  • Avatar
    Rachael

    The 'Post Payment' option will allow you to post the payments listed on the ERA to all patients at the same time. The 'Mark as Processed' option allows you to process the ERA without posting the payment, in the event that the ERA is a duplicate, or a payment has already been posted. If you have further questions, please contact our Support Team at 215-658-4550 or by email at Support@TherapyNotes.com. Thank you.