ERA List

Claims / ERA List Add Notes and Copayments to Billing Entries from the ERA List

To add notes and copayments to billing entries: 

  1. Navigate to the Payments tab in the ERA payments reconciliation window
  2. Under “Service Lines,” click the Actions drop-down and select View All Billing Entries

  3. Click the + next to a billing entry to display all of the line items from the claim
  4. To add a copay, select Activity in the “Payment type” drop-down
  5. Click Adjustments in the Notes column
  6. In the pop-up, complete the following fields:

    • Group: select PR – Patient Responsibility
    • Code: enter 2 – Coinsurance amount
    • Amount: enter the amount charged
  7. Click Done
  8. Enter notes in the Notes column, if any
  9. Click Add

Click here to learn how to use the ERA List.

Claims / Claims / ERA List How to Use the ERA Payments Screen Filters

When selecting a claim, the Filters panel on the left-hand side contains filters to view specific payments with an orphaned claim/service, types of insurance, claims IDs, payors, and reconciliation status. 

  1. Navigate to the Claims module and select ERA List 
  2. Filter the ERA list by date and select a claim 
  3. Click the funnel icon on the left-hand side to view the Claims filters 
  4. Apply the following filters: 
    • Claims: filter by claims or services. 
      • Orphaned Claims: filter by orphaned claims or services within an ERA. 
        • Select Yes to display orphaned claims and services. 
        • Select No to display claims that are not orphaned or do not contain orphaned service lines. 
      • Claim ID: search and select claim IDs. 
    • Clients: select clients from a drop-down or search and select multiple clients.
    • Reconciledfilters by claims that have already been reconciled. 
      • Select Yes to display reconciled claims. 
      • Select No to display claims that need review. 
      • The following selections are available in the Auto Reconciliation Status drop-down: 
        • Complete 
        • Combined Service 
        • Mismatch Service 
        • Orphaned Claim 
        • Orphaned Service 
        • Void Billing Entry 
        • Unbalanced Amount 
    • Payer: filters by clients’ primary or secondary insurance within an ERA. Search for specific payors, filter by Primary or Secondary options, or select a specific group code in the “Group” drop-down. The following are group options:  
      • CO: Contractual Obligations 
      • CR: Correction and Reversals 
      • OA: Other Adjustments 
      • PI: Payor Initiated Reductions 
      • PR: Patient Responsibility 

Claims / ERA List How to Post Orphaned ERA Data in CentralReach

When CentralReach exports EDI claims, a reference value is added to each claim line. CentralReach uses reference values to match a claim line, or combined claim lines, to billing entries on the billing screen. These values are typically returned in the 835/ERA file. However, if the reference value is not returned in the 835/ERA file, CentralReach cannot locate the exact entry and will categorize it as “Orphaned.”

Orphaned data is data that cannot be matched to any original submission information. This can occur because:

  • The data was never in CentralReach (e.g. The dates of service pre-date the transition to CR)
  • The data was entered on a web portal or sent via a paper claim
  • The data was reprocessed and the payor did not return the correct reference data for each line item
  • The payor is not returning the reference information

To post orphaned data from an ERA:

  1. Navigate to the Claims module and select ERA List
  2. Click the blue Id number to open the ERA
  3. Under the “Service Lines” column, clients and service lines can be marked as Orphaned
    orphan 1

    • If there is orphaned client data:
      • Click Orphaned Client
      • In the edit screen, enter the Era Patient and MI – Member ID Number
      • Select the payor in the Payor drop-down
      • Click the  checkmark 
    • If there is orphaned claims data:
      • Click the Orphaned service line
      • In the Choose billing entries for pop-up, the yellow line will contain the ERA information. CentralReach will default to the day and client indicated in that line and populate potential billing entries
      • Click the  checkbox next to the entry to match
      • Click Apply Changes 
      • If needed, repeat for each orphaned service line

ERA data can also be downloaded from the payor, a clearinghouse, or CentralReach.

To download the ERA report via CentralReach:

  1. Navigate to the Claims module and select ERA List
  2. Click the cloud  icon 

Click here to learn how to use the ERA List.

Claims / ERA List How to Use the ERA List and Reconcile Button

The ERA list contains summaries of ERAs in single rows, as well as reconciled payment information. From this screen, payments can also be reconciled. Please note, the information from the ERA List contains the same data as an EOB.

To use the ERA List:

  1. Navigate to the Claims module and select ERA List
  2. The screen will display a list of ERA payments, sorted by CR payment ID number. The list contains:

    • Id: The CR payment ID number
    • Received: The date of payment
    • Claim: ERA information for total claim adjustments
    • Provider: ERA information for total provider adjustments
    • Service Line Adjustments: ERA information for total service line adjustments, totals of various claim adjustments, patient responsibility amounts, and payment amounts, as read by the ERA
    • Reconciled: Totals reconciled in CentralReach 
      • Please note, reconciled information will not display until users reconcile some portion of the ERA.
    • Reconcile Status: The reconciliation status. There are four reconciliation statuses in CentralReach:
      • None: No data has been posted
      • Partially: Some data has been posted, but the “Paid” amount is less than the “Insurance Paid” amount
      • Fully: All payments have been posted. 
        • Please note, this only refers to the “Insurance Paid Amount” vs the amount you have posted in CR, (i.e. if those 2 amounts are equal, you will see ‘Fully’. If any amounts in CR are “Orphaned,” or partially posted in a manual fashion, those ERA’s will not show “Fully.”) 
          • In those cases we recommend using a label/tag to let staff know what has happened. If you manually post, and the check number is an exact character for character match, the “Paid” amount will reflect it.
      • Over: The payment amount posted is greater than the amount of the ERA
  3. By default, the ERA List will display the last 7 days of ERA data. Click the calendar  icon to adjust the date range
  4. Click the columns  icon on the right-hand side to add and remove columns displayed on the grid
    • To rearrange columns in the grid, hover over the column title and drag the  icon to the desired location
  5. Click the  icon to complete the following options:

    • Pin Column: select one of the following:
      • Pin Left: moves column to the left side of the grid
      • Pin Right: moves column to the right side of the grid
      • No Pin: moves column to its default location
    • Autosize This Column: sizes the select column to best fit on the grid
    • Autosize All Columns: sizes all columns to best fit on the grid
    • Group by: groups ERAs by the selected column
    • Reset Columns: restores all column adjustments to default
    • Tool Panel: opens sidebar to add or remove columns from the grid
  6. In the pop-up, click the  funnel tab to apply filters to the column

To reconcile payments from the ERA List:

  1. Under the Id column, click a blue CR Payment Id number
  2. The ERA payments reconciliation screen will open in a new window. By default, it will display the Payments tab, which contains:
    • Service Lines: the service line information in the claim
    • Client Payer: the client payor associated with the service line
      • To edit the client payor: 
        • Click Change Payor
        • Select a payor from the drop-down in the “Edit ALL Payors” pop-up
        • Click the check
    • Payment Type: the type of payment associated with the service line
      • To edit the payment type:
        • Click Change Payment Type
        • Select a payment type from the drop-down in the “Edit ALL Payment Types” pop-up
        • Click the check
    • Billing Entry Info/Claim Charges: the billing entry information from the billing screen
    • Adjustment Reason: adjustment reasons posted to billing entries, if you choose to post them
    • ERA/835/EOB: ERA information, as it appears in the data file
    • Reconciled in CentralReach: the amounts and dates payments were reconciled in CentralReach
      • Amounts in black font indicate that the line item has not been posted or reconciled.
      • Amounts in blue font are links to data from the billing screen and indicate the line item was reconciled.
  3. Click the 835 Details tab to view the summation of payment data

    • Please note, if all of the data was not imported, there will be a sum of the amount of orphaned data. Orphaned data is data that cannot be matched to any original submission information.
  4. CentralReach can reconcile all, or some, of the payments in the grid
    • To reconcile select service lines:
      • Select service lines to be reconciled by clicking the checkbox  next to the entries
      • Click Reconcile checked
      • Click Yes
    • To reconcile all service lines:
      • Click Reconcile All on the top right-hand corner of the screen
      • Click Yes
  5. Repeat steps 1-4 to post more payments
  6. Provider level adjustments can also be reconciled by clicking the Adjustments tab in the ERA payments reconciliation screen
  7. Click Set Billing Info to set the billing entry information and add a timesheet
  8. In the “Billing Entry Settings” pop-up, complete the fields for the new billing entry
  9. Click Apply Changes

Please note: 

  • The system will present a warning if previously reconciled payments are attempted to be reconciled again. Reconciling them again will create duplicate payments.
  • Amounts under the “Patient Responsibility” column are only updated in the column and do not post the data as a payment.

Now that sales adjustments and reconciled payments have been posted, the ERA payments reconciliation window will show the applied amounts in blue. Users can view all of the billing entries with the newly reconciled payments, as well as add notes and post copay amounts.

Click here to learn how to post orphaned data.
Click here to learn how to reconcile payments.
Click here to learn how to add notes and copayments to billing entries.