View ERA

This page allows users to view, download, and send Electronic Remittance Advice (ERA). After completing enrollment (see Provider Enrollment), payers will begin submitting ERA to Claim.MD once the enrollment is processed. This process typically takes at least a week. It is essential to monitor both the previous EDI system and Claim.MD during the first two weeks to ensure that no ERA transmissions are missed. If ERAs do not appear within a week after enrollment, contact the payer's ERA department for assistance.

1. In the left-hand navigation menu, click View ERA.

• The View ERA list displays individual ERA files received from the payer. By default, only unviewed ERAs are shown.
• Additional viewing options include Pending Download, Payments from the Last 30 Days, and Monthly Payments.
• Key details displayed include EFT / Check #, payment amount, provider pay date, and provider NPI. Click the EFT# to open a detailed PDF view of the ERA.

Searching for an ERA

• To find a specific ERA, click the   Search  button and enter the search criteria in the pop-up window.

Downloading an ERA

ERA files can be downloaded in the X12 format and saved locally for later use. These files can then be uploaded into a Practice Management System or another healthcare platform.

1. Select the checkbox next to the ERA you want to download. To select all ERAs, click the checkbox at the top of the list.
2. At the bottom left of the screen, click the Select Action dropdown.
3. Choose Download Selected 835.

Sending ERA to an SFTP Server

ERAs can be sent to an SFTP server configured for communication with Claim.MD. For setup instructions, see SFTP Setup. It is recommended to periodically push these files to the SFTP server for processing.

• At the bottom left of the screen, click the Select Action dropdown.
• Click Send to SFTP Server.

Adding Notes to an ERA

1. Click the Selected Action dropdown.
2. Select Add Notes.
3. A Notes field will appear. Enter your notes, then click Save.
   
4. The saved notes will display with the date and time of entry, the user who created the note, and the note content.
   

Requesting Assistance for an ERA

1. Click the Selected Action dropdown next to the ERA record.
2. Select Get Help from the dropdown menu.
3. A support ticket form will appear on the right. You can either link the ERA to an existing ticket from the dropdown menu or leave it set to the default New Issue. Enter a detailed description of your issue.
4. Click the Submit Support Request button at the bottom of the window.

Missing ERA Tickets

If an ERA is missing from the View ERA page, submit a support ticket in the general Support Tickets section instead of through the View ERA page.

Viewing Individual Patient Claim Information on an ERA

This option provides a list of individual patients associated with an ERA, allowing you to find details for a specific patient.

1. Click the Selected Action dropdown next to the ERA record.
2. Select Single Patient from the dropdown menu.
3. A list of patient claim information will appear, sorted alphabetically by patient name. Click a patient’s name to view details specific to that patient without displaying other patient records from the ERA.
   

Viewing Zero Pay Records

This option displays records of patients whose claims resulted in no payment (e.g., denials).

1. Click the Selected Action dropdown next to the ERA record.
2. Select Zero Pays from the dropdown menu.
3. A list of zero pay patient records for the selected ERA will be displayed.

Locating Claims Associated with an ERA

There are times when you may need to review a claim associated with an ERA for correction, appeal, or other purposes. Claim.MD provides a straightforward way to access these claims from the View ERA page.

To locate claims linked to an ERA:

1. Click the Selected Action dropdown next to the ERA record.
2. Select Locate Claims from the dropdown menu.
3. A list of patient claim records associated with the selected ERA will be displayed. Click on an individual claim to view its details.

Filtering ERA Activity Status

Users can filter ERAs based on their activity status, such as whether they have been viewed, downloaded, or sent via SFTP.

You can filter remittances based on whether they have not been viewed or downloaded by you or not been viewed or downloaded by any user. To do this, use the "By" dropdown located at the bottom right of the screen (see image above).

Note: When selecting "Pending Download" or "Unviewed" in the dropdown, only ERAs from the past three months will be displayed.

If you need to access ERAs beyond this range, open the search pop-up box and click "Search" without entering specific criteria. This will display all available ERAs.

 

Guide to Viewing ERA (Electronic Remittance Advice)

Use the instructions below to filter ERA based on viewing or download status.

Understanding Dropdown Options

• Me: Displays ERA that have been manually downloaded by you.
• Anyone: Displays ERA that have been manually downloaded by any user within the organization.
• SFTP/API: Displays ERA that have been sent via SFTP or API by you.
• All Users + SFTP/API: Displays ERA that have been downloaded manually by users or automatically via API or SFTP.

Viewing ERA Status

To display ERA that have not been viewed by you:

1. Select Un-Viewed from the top-right dropdown.
2. Select Me from the bottom-right dropdown.

To display ERA that have not been viewed by any user:

1. Select Un-Viewed from the top-right dropdown.
2. Select Anyone from the bottom-right dropdown.

Downloading ERA Status

To view ERA that have not been manually downloaded by you:

1. Select Pending Download from the top-right dropdown.
2. Select Me from the bottom-right dropdown.

To view ERA that have not been manually downloaded by any user:

1. Select Pending Download from the top-right dropdown.
2. Select Anyone from the bottom-right dropdown.

To view ERA that have been sent via SFTP/API but not manually downloaded:

1. Select Pending Download from the top-right dropdown.
2. Select SFTP/API from the bottom-right dropdown.

To view ERA that have been downloaded manually or via SFTP/API:

1. Select Pending Download from the top-right dropdown.
2. Select All Users + SFTP/API from the bottom-right dropdown.

These filters allow you to efficiently track the status of ERA views and downloads across your organization.

Viewing ERA Within Specific Time Frames

• To view all ERA from the past 7 days: Select Past Week Payments from the top-right dropdown. This will display all ERA from that period, regardless of their viewing or download status.
• To view all ERA from the past 30 days: Select Past 30 Days Payments from the top-right dropdown. This will display all ERA from that time frame, regardless of their viewing or download status.
• To view ERA by monthly data (from the past year): Select (Month / Year) Payments (e.g., "February 2023 Payments") from the top-right dropdown. This will display all ERA for that period, regardless of their viewing or download status.

Icons and Their Meanings

• Viewed ERA: An eye icon next to an ERA indicates that it has been viewed.
  This icon signifies that the ERA has been viewed by you or anyone, depending on the dropdown selection.
  
• Downloaded ERA: If an ERA is downloaded using the Download Selected 835 option in the Select Action dropdown, a blue checkmark will appear next to the ERA. If an ERA has been both viewed and downloaded, both an eye icon and a checkmark will be displayed.
  This icon signifies that the ERA has been downloaded by you or anyone, depending on the dropdown selection.
  
• ERA Uploaded via SFTP: If you need to verify whether an ERA has been uploaded to your system via SFTP, go to the View ERA section in your Claim.MD account and look for the SFTP download icon. If you see the icon next to the record (shown below), the ERA has already been uploaded to your account.