Receiving Manually Recovered ERAs

Occasionally, Electronic Remittance Advice (ERAs) are received by Claim.MD but cannot be matched automatically to an account or specific claim due to mismatches in the received data. This article explains why this happens, how ERAs are manually recovered, and what users need to know when trying to locate the ERA once it has been assigned to their Claim.MD account.

What is the Claim.MD Unassigned ERA Database?
This is a system-managed location where ERAs are held when they cannot be matched to a Claim.MD account automatically. These ERAs are accessible to Claim.MD support agents and can be manually assigned to an account when requested in a Claim.MD support ticket.

Why ERA Are Unassigned

Unassigned ERA are typically caused by the payer and/or the payer's ERA trading partner.

Note: If this issue occurs frequently, it may be helpful to reach out to the payer to discuss how the ERA are being received/delivered.

Common causes ERA are unassigned include:

The payer or the payer's ERA trading partner returns the ERA with an NPI and/or Tax ID not listed in the Claim.MD account under Prov. Enrollment.
The ERA returns with no NPI or no Tax ID.

How to identify an Unassigned ERA in Show History/Notes

When reviewing claim history, you may see a reference under Event that presents as External Account which will have an EFT/Check number, status (Paid or Denied), procedure code(s) and the amount paid. This indicates the ERA has been received but could not be assigned to the account automatically.

Note: External Account can also involve ERA that have been delivered to another Claim.MD account. That is an entirely different issue and is not handled in the same way as an unassigned ERA.

Refer to the Show History/Notes article for detailed instructions on viewing a claim’s history and notes.

What to do when you see there is an ERA in an External Account

Open a support ticket from the claim that has the payment reflected in Claim History as External Account. Ask Support to research the ERA. Once the ERA is located by Support, you may be provided additional information such as why the ERA was unable to be assigned to the account, that more ERA have been located, as well as the received date range if more than one ERA have been located.

Note: You will be asked to confirm if you want all ERA located in the received date range, only the one ERA originally located, or ERA from a specific date range.

You will be instructed to add the needed provider information in Prov. Enrollment in Claim.MD so that the ERA can be assigned to the account by Support.

When Claim.MD Support Recovers an ERA

Once the ERA is successfully recovered and linked to your account, you’ll be able to view it in View/Download ERA.

Note: ERA that have been manually assigned by Support, may not appear in your current View/Download ERA list unless you filter by the original receive date or received date range. If there are multiple ERA spanning a date range, that date range will be provided in the support ticket response.

Note: Please remember for those users who have Small Volume or Basic Plan, each claim listed on the ERA will have a transaction fee per claim. Please check our website for plan and pricing details. For those users with Unlimited Plan, if the Tax ID is different than what is currently listed in the Claim.MD account, there will be an additional charge of $25 per Tax ID/EIN or SSN.

How to locate recovered ERA

Set the date filter in the View ERA screen to include the month the ERA was originally received.
Look for the ERA in the ERA list once the correct date is applied.

Manual ERA Delivery to SFTP Server

When an ERA is manually assigned to an account, it does not automatically post to the SFTP server. This is intentional to prevent the risk of sending duplicate files that may have already been received through other channels. To deliver these ERAs via SFTP, you must use the "Send to SFTP"option to manually select and send the appropriate files.

These ERAs are typically older and were likely delivered previously. To resend one through the SFTP server,locate it using the feature, select the desired ERA, and then use the “Send to SFTP” action to complete the delivery.