Overview

The Payment Batch: Import page is used to manage Electronic Remittance Advice (ERA) files for insurance payments. 

It contains a list of ERA files received from payers. Use the page to import distributions from the ERA file into a payments batch. A payment batch is created for each ERA file that is imported. Any ERA file containing distributions not positively identified are reported as unresolved distributions. All unresolved distributions must be resolved before they can be imported. Unresolved payments are a result of claims for which the distribution is not positively identified in the ERA file. Some distributions might include warnings. Warnings do not have to be resolved before the payments can be imported.

The Search Criteria window includes the Archive Status options to filter search results by archived ERA files or all ERA files. The label on the button under the Download button will be either Archive or Unarchive based on the filter selection. Archived files cannot be imported and are excluded from error checking. Archived ERA files do not have values in the Unresolved and Warnings columns.

How to Get Here?

To open the Payment Batch: Import page:

From the Home Page:From the Menus:Via Shortcut Keys:
  1. Click Payment Batches from the Manage list.
  2. Click Import.
  1. Open the Manage menu and select Payment Batches.
  2. Click Import.
  1. Press [Alt] + [M] + [P].
  2. Press [Alt] + [I].

 


Field Definitions

Field

Type

Required

Description

Practice

Display Only

(pulled from ERA file)

YesThe practice associated with the payment batch.
ERA ID

Display Only

(pulled from ERA file)

YesThe identification number assigned to the ERA file when it is imported into a payment batch.
Payer Name

Display Only

(pulled from ERA file)

YesThe name of the payer who sent the ERA file.
Check/EFT Number

Display Only

(pulled from ERA file)

YesThe unique check number or electronic funds transfer (EFT) identification of the ERA file.
Payer ID

Display Only

(pulled from ERA file)

YesThe unique payer identification number (REF 2U value of the ERA file).
Override Payer ID

Display Only

(pulled from Override values)

NoThe unique payer identification number entered/populated in the Override > Override ID > Payer ID field.
File Name

Display Only

(pulled from ERA file)

YesThe name of the electronic remittance advice file.
Date

Display Only

(pulled from ERA file)

YesThe date on the check or ERA file. By default, the table is sorted by this column in ascending order.
Amount

Display Only

(pulled from ERA file)

YesThe total amount of the check or electronic funds transfer for the ERA file.
Distributions

Display Only

(pulled from ERA file)

YesThe total number of payments, recoups and denials from the payer.

Button Descriptions

Button

Shortcut Keys

Description

Step-By-Step Guides

Search[Alt] + [S]To find ERA file.
  1. Click Search. The Search Criteria window opens.
  2. Enter search criteria.
  3. Click OK.
Download[Alt] + [D]To download the ERA file from the clearinghouse to output data from the ERA file to the standard Medicare EOB form through the Medicare Easy Print software.
  1. Select the ERA file to download.
  2. Click Download. The Save As window opens.
  3. Specify where to save the ERA file to access later and click Save.
Archive / Unarchive[Alt] + [A]

To archive the specified ERA file(s). By default, the label on the button is Archive. This label is based on the selection in the Archive Status filter.

  • When the filter is set to Archived, the button label is Unarchive.
  • When the filter is set to Not Archived or Both, the button label is Archive.
  1. Select the ERA file to archive/unarchive.
  2. Click Archive/Unarchive. The Archive Status on the ERA file is updated accordingly.
  3. Update the Archive Status filter in the Search window to view the files with the desired status.
Import[Alt] + [P]

To import the insurance distributions in the ERA file into a payment batch.





  1. Select the ERA file to import.
  2. Click Import. The ERA file is validated for errors:

    • If no errors are found, the Import Payment from [Payer] window opens prompting you for an accounting date (if applicable) and the payer of the ERA file.

    • If errors are found, a confirmation message appears to inform you of this condition. You must click Resolve Payments or Cancel Import. If you click Resolve Payments, the Resolve Payments: [ID] page opens where you must map the service lines of an unresolved payment to the applicable claims. All unresolved payments in the ERA file must be resolved before the payments can be imported into the payment batch.

  3. A payment batch is created for each ERA file that is imported.
  4. The payment batch is not automatically posted. Verify that the insurance payment has been distributed as expected, and then post the payment batch through the standard posting process.
  5. If the insurance payment amount does not balance with the amount that was originally billed on a claim, the ERA process creates an adjustment (if the Reason Code allows it), which is listed on the Remit Detail report.
  6. When the import process is completed, the Import Exceptions tab appears.
Override[Alt] + [O]

To override the Payer ID value. This may be necessary if an ERA does not contact a Payer ID value, or you wish to override the existing value.

If the ERA file did not contain a REF 2U value and the Payer ID column is blank, the system will not allow the ERA to be imported. You must click Override and enter/select the appropriate Additional Payer ID value.

If a Payer ID value existed prior to overriding, the previous value will remain in the Payer ID column and remain attached to the file for historical purposes. The Additional Payer IDs value will be used to process the ERA.
  1. Select the ERA file with the Payer ID to override.
  2. Click Override. The Additional Payer IDs window opens.
  3. Review the following Check information:
    • Payer Name
    • Check/EFT Number
    • Payer ID
    • Date
    • Amount
  4. If no Payer ID is present, enter the 5-50 character Payer ID in the Payer ID field.
  5. In the ERA Override Payer ID section, open the Plan field and select the plan that sent the ERA.
  6. The Additional Payer IDs section is auto-populated with the plan's Payer ID. Note: Up to 6 additional Payer IDs may be added to the override list. The additional Payer IDs added can be deleted from the list by clicking the red X next to the ID.
  7. Click OK.
Print Remit[Alt] + [T]To generate the Remit Detail report, which mimics the information presented on the Claim Detail tab of the Medicare Remit Easy Print software. This option lists the claim detail for all Electronic Remittance Advice (ERA) service line transactions rolled into a single payment. It also displays denial and adjustment code descriptions in the summary section near the end of the report.
  1. From the Payment Batch: Import page, click Print Remit. The Claim Detail report opens.
  2. Use the report toolbar to preview, save, or print the report.
  3. Click the  in the upper right corner of the report to close it.


 

Related Topics

Payment Batches

Payment Batches Page

Payment Batch / Payment Batch Information Tab

Payment Batch / Image Batches Tab

Payment Batch / Import Exceptions Tab

Payment (Insurance) Page

Payment (Guarantor) Page

Payment (External Collections) Page

Distribution: [ID] Page

Resolve Payments: [ID] Page

Creating Payment Batches

Updating Payment Batches

Importing ERA Files

Posting Payment Batches

Deleting Payment Batches

Applying Insurance Payments

Applying Guarantor Payments

Applying External Collections Payments

Updating Payments

Transferring Payments to Suspense

Transferring Money to Miscellaneous Income

Applying Rescinded Payments (Insurance Payment)

Applying Rescinded Payments (External Collections)

Adding Service Line Distributions (Insurance Payment)

Updating Service Line Distributions (Insurance Payment)

Adding Service Line Distributions (Guarantor Payment)

Adding On Account Distributions (Guarantor Payment)

Adding Service Line Distributions (External Collections)

Linking/Unlinking Images to Service Line Distributions

Resolving Payments





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