Claims can only be archived if they have been exported. If a claim has not been exported, it can be deleted.

To archive claims:

1. Navigate to the Claims module and select Claims Manager
2. On the right-hand side of each claim click on the Actions drop-down and select Archive or Delete
3. The claim will be placed in the respective folder
   • It is recommended that once a claim is deleted, it stays deleted. The deleted claim can be remade if it is needed.

The Claims report contains all claim data in the Claims module.

To download the Claims report:

1. Navigate to the Claims module and select Claims Manager
2. Choose a desired date range by selecting the calendar at the top of the screen
3. Filter the screen and click the  cloud icon on the right-hand side 
4. Select CSV or Text file
5. The file will be generated and located in the Files module

The “Filter by [Gateway]” filter in the Claims module allows users to filter entries by gateways.

To filter the “Claims Manager” by gateway:

1. Navigate to the Claims module and select Claims Manager
2. Click the funnel icon on the left-side hand and then the Filters tab
3. Click Gateways
   
4. Next to “Filter by Gateway,” click Choose  and select an active gateway to filter the screen

Click here to learn more about clearinghouse enrollment and setup.

To view edits and claim history:

1. Navigate to the Claims module and select Claims Manager
2. On the right-hand side of the claim, click the Actions drop-down and select View History
3. The “Claim History” pop-up will display all recent activity related to the claim
   • Please note, for Change Healthcare users, if a claim has been linked to a human readable EOB report, the report will display here and can be accessed in the Files module.

To add a billing entry to a claim:

1. Navigate to the Claims module and select Claims Manager
2. Search for the claim ID in the search bar, or find the claim to be edited in the grid
3. Click the Actions  drop-down next to the claim on the right-hand side of the grid and select Edit
4. Click the Services tab on the top of the claim
5. Click the Add New  drop-down under “Service Lines” and select one of the following:
   • Add Manual Line: use if the billing entry has not been created in CentralReach
     • Enter the information under the Details, Rendering Provider, and Ordering Provider tabs
       • The “Ordering Provider” tab is to include the ordering physician on a service line, if the provider differs with the rendering provider.
   • Add Existing Billing Entry: use if the billing entry has already been created in CentralReach. Once clicked, a “Choose Existing Entries” pop-up will display the list of billing entries with the same client and the same billing date as the entries already registered in the claim. Billing entries already included in other claims will be excluded from the list
     • Check the billing entries(s) that need to be added to the claim
     • Click Apply Billing Entries
       

6. Click Save Claim

Please note, If you are adding a line item that is the same date and code as one already on the claim, this action will not ‘combine’ the units and dollar amounts together. Instead, it will submit the line items as they read on this page and possibly create a duplicate.

To identify claims generated, but not yet submitted to a clearinghouse:

1. Navigate to the Claims module and select Claims Manager
2. Click the Inbox button on the top of the page

3. The list of claims that have not been submitted to the gateway will be displayed, along with the list of claims processed manually

4. If a 1500 form was exported to process the claim manually, click the link under the Exported column to retrieve the claim information

To verify a claim has been submitted via a gateway:

1. Navigate to the Claims module and select Claims Manager
2. Click on the Sent button on the top of the page to view the claims being processed via the gateway. If a claim is in the sent folder for more than 48 hours, further review the claim, as this is an indicator that the claim was not successfully sent
3. Click the Responses button on the top of the page to view all of the claim responses

When re-submitting a claim, the original reference number may be required by the gateway. The original reference number, also called the payor claim control number, is assigned by the payor and located on the payor’s website.

To locate the original reference number:

1. Navigate to the Claims module and select Claims Manager
2. Next to the desired claim, click the Actions drop-down and select Edit
3. Click the Claim tab and select Details
   

Please note:

• If the claim has already been exported as a PDF file, the reference number will be in the Original Ref. No. box next to box 22.
  
  
• If the claim has been exported as an excel file, the reference number will be found in the PayerClaimControlNumber column in the spreadsheet.

Click here to learn how to re-submit claims.

To print text only on a blank, pre-existing CMS 1500 form:

1. Navigate to the Claims module and select Claims Manager
2. Select the claims to be exported. Click the Actions drop-down and select Export/Download
3. Select CMS 1500 (PDF) from the drop-down and click Export
   
4. Click on download from the “Claims export progress” window on the bottom-right
   
5. A pop-up window will appear to save the file locally. Right-click the Download link and select Save link as…
6. Open the local file with your system’s PDF reader. Navigate to “Save and Print Options” and select Print Text Only
   

To pull information, such as NPI, tax ID, or address of another office location into a claim, you first need to create a generic contact for such location, via the Contacts module. Click here to learn how to create a generic contact.

Once the office location is added via a generic contact, complete the Claim Settings of this office location contact:

1. Navigate to the Contacts module and select Generics
2. Select a contact
3. Click the Profile tab on the top of the Dashboard
4. Click the Settings tab and select Claim Settings
5. Complete the form with all of the information pertaining to your office location
6. Click Save Claim Settings

Once done, you can pull your generic contact office location information into your claims.

Splitting claims by different providers is primarily designed for Tricare submitters, but can also be helpful for multidisciplinary providers, such as SLP, OT, and PT.

To split claims by different providers:

1. Navigate to the Billing module and select Billing
2. Select the billing entries to be split
3. Click the Actions drop-down and select Bulk Merge Claims
   
   
4. On the next screen, there will be one claim for one client. Click the Split on Providers checkbox. The claim will split into one claim per client and per provider
   
5. Click Start claims generation once all changes have been finalized on the current, bulk-merge screen
6. Once the claims have been processed, they can be submitted. To submit the claims, navigate to Go to claims inbox
7. Select the claims to be submitted. Click the Actions drop-down and select Send to Gateway
   
   

Please note, while this feature is primarily designed for one client at a time, it can handle multiple clients and staff. If handling more than one client, please be aware each step may take longer to complete.

The loops and segments of the 837P are built into the Claims module, so when you are analyzing the CMS-1500 claims, you can see how each box of the CMS-1500 form will translate to in 837P.

In order to see the loops and segments of 837P:

1. Navigate to Claims module and select Claims Manager
2. Next to the generated claim, click the Actions drop-down and then click Edit
3. Fields with dotted underlines correspond to areas or boxes on the CMS 1500 insurance form. Clicking on the field names will display a pop-up of where the information will populate on CMS 1500 forms and 837p specifications
   
4. Click Add to view and edit the client’s default claims settings

CentralReach allows users to enter a service address into timesheets that will be displayed in claims. If a timesheet has a service location, this location will be used for the facility address when generating a claim. 

Please note, this function is used if the payor requires the service location on the claim form.

To utilize the Service Location function:

1. Create an authorization or edit an existing one
   • Please note, if bulk-merging claims with multiple entries and multiple service locations while Split on Service Location is checked, the system will split the claims per service location. 
2. Click + Add Codes and select Add Single Code or Add Grouped Codes 
3. Under the General tab, click the Use Service Location toggle, turning it green
   
   
4. Click Save

To enter a service address in a claim:

1. Create a new timesheet by navigating to the Billing module and selecting + Add New Timesheet
   • Or, edit an existing timesheet
2. Select a service address in the Service address drop-down under the “Service Lines” section
   
   
3. Click Save
4. Generate a claim. When generating the claim, check Split on Service Location
   • Please note: 
     • If bulk-generating claims with two entries that have two different locations, and Split on Service Location is checked, the system will split the claims into two claims.
     • If Split on Service Location is unchecked, and the client’s authorization is not properly set up to “Use Service Location,” the service address will not appear in box 32 of the claim. Instead, the billing provider’s location information will populate.
       • If there is no billing provider location, the claim form will generate a blank box 32.

CentralReach can automatically add times to claims while bulk-merging. These times are pulled from timesheet information in the system. Although this feature can be used when submitting claims to any payor, it was primarily implemented for submitting to Tricare.

To include times on claims:

1. Navigate to the Billing module and select Billing
2. Check the billing entries to be bulk-merged
3. In the Actions drop-down, select Bulk-merge Claims 
4. Check Include Times to automatically add times to claims
   
   • Please note, if the times are split, the multiple times will also appear on the individual lines’ notes section.
5. Once the claim has been generated, the timesheet times will be added to the service line notes in CentralReach and CMS 1500 forms
   • To locate the times on CentralReach:
     • Within a claim, click the Services tab
     • Click an individual service line under Service Lines
     • The time will be noted in the Notes section of the Details tab
       
       
   • The times will be listed on CMS 1500 forms above each line item in box 24
     
     

Click here to learn how to bulk-merge claims for Tricare.

CentralReach supports diagnosis codes from ICD-9 and ICD-10. It is recommended for users to transition to ICD-10, if billing is being generated for dates of services on or after October 1, 2015. 

Only one code set can be used:

• For contacts, authorizations, and timesheets
• While bulk-merging claims
  • If there are timesheets with two different code sets, the system will flag this and prompt users to select ICD-9 or ICD-10. Users will be unable to bulk-merge until a code set is selected.
• In the Claims Manager

Please note, once a code set is selected, the system will only permit diagnosis codes from that code set to be added to an entry. Users can only add codes from the same set, i.e. ICD-9 or ICD-10.

Click here to learn how to add a diagnosis code to a client’s Profile.

Example of ICD-9 usage:

Example of ICD-10 usage:

Diagnosis codes are in contacts’ Profiles, as well as the following places:

• In an authorization, users can specify the diagnosis code and this will override the default diagnosis code from the client’s Claim Settings.
  • If a default code is added in the client’s Claim Settings as ICD-10, and you want to also specify the diagnosis code on the authorized service lines, make sure there are no differing ICD-9 codes set up. Otherwise, this will result in mixed timesheets.

• In a timesheet, click Show Claim Info to reveal the diagnosis codes and claim settings for that individual timesheet.
  

• In a claim, click on the + next to “Diag Codes” to search for ICD-9 or ICD-10 codes. Please note, when adding a different diagnosis code version, you cannot merge the claim until one code version is the only ICD code set on the claims. Once one version is selected, complete the merge process.
  • Users can also edit the diagnosis code in the claims editor.
    

There are two methods to submit corrected or replacement claims and void claims, depending on if ERAs are used.

Prior to submitting corrected, replacement, or voided claims, be sure to:

• Correct timesheet(s) being replaced before regenerating the claim
• Have the original claim ID number from the payor. Without this internal identifier, the payor will be unable to pinpoint the original claim being modified. 
  • Please note, corrected and voided claims cannot be sent to the payor until, at minimum, the original claim has been entered into the payor’s system and has been assigned a retrievable claim number.
• Replace all line items on the claim, if replacing a claim. 
  • i.e. If the original claim had 10 line items and one line needs to be corrected, resend the claim with the corrected line and the other nine lines as they originally appeared on the claim. 
    • When payors correct claims, they void the original claim and reprocess the claim with all items being resubmitted, including corrected items.

Once claims data has been audited, corrected, replacement, and voided claims can be sent. There are two ways to do so: 

1. Edit the timesheet and then bulk merge the claim.
2. If you received an ERA for the claim, correct the claim from the ERA screen.

To submit corrected or replacement claims:

1. Edit the timesheet information to reflect desired changes
2. Regenerate the claim being replaced
3. Navigate to the Claims module and select Claims Manager
4. Click the Actions  drop-down on the right-hand side of the claim and select Edit
5. Click the Claim tab in the Claims editor
   
   
6. In the Submission Reason drop-down, the claim will have “1 – Original” selected by default. Click the drop-down and select one of the following:
   • 6 – Corrected
   • 7 – Replacement 
   • 8 – Void
7. Enter the original claim ID number in the Original Reference No textbox
8. Click Save Claim. The claim can now be submitted as usual

Please note, the number with the corresponding Submission Reason and the Original Reference No will populate in box 22 on CMS 1500 forms.

To submit corrected or replacement claims, if an ERA was received for the claim in question:

1. Navigate to the Claims module and select ERA List
2. Under the Id column, click on the blue CR payment ID number with the service lines you want to edit
   
3. Click the Actions  drop-down in the “Services Lines” column and select New corrected claim. This will redirect you to the bulk merge screen, where you can generate the claim, as needed.
   
   
   • The claim will generate with a Submission Reason of “7 – Replacement.”
4. Complete steps 2-8, as directed in the first method above and resubmit as usual

Click here to learn how to regenerate and bulk-merge claims.
Click here to learn how to locate the original claim reference number.

TriCare has a different set of requirements for submitting claims electronically, which vary by region. Organizations should review requirements for their region.

Employees, including RBTs, working with TriCare should be set up with NPI numbers. To enter NPI numbers:

1. Navigate to the employee’s Claim Settings
2. Add the employee’s full name and NPI to their profile

To bulk-merge claims for TriCare:

1. Navigate to the Billing module and select Billing
2. Check the billing entries to be bulk-merged
3. Click Bulk-merge Claims in the Actions drop-down
4. Check Split on Providers
   • Please note, claims need to be generated, one for each provider/client combination, when submitting to TriCare.
     • E.g., If two RBTs serviced one client, two individual claims need to be generated for each RBT.
5. Check Include Times to automatically add times to claims. Users should ensure that the organization account is set up to use military time format, as well.
6. Click the arrow  to expand the codes to be billed
7. In the “Provider” column, click the gear  icon and select Sync to provider supplier. This will copy the data from the Provider column to the Provider/Supplier column quickly.
   • Please note, TriCare also requires one line on a claim per billing entry. On the bulk merge screen, users should use the default “Separated claims view” setting on the left-hand side. This is due to the unique timestamps in military time that are required to stay separated.
8. Click Start claims generation
9. Click Go to claims inbox
   • Or, click the Claim # next to “Status”.

Click here to learn how to bulk-merge claims for other payors.

Prior to bulk-merging claims, audit the claims data to ensure they are submitted correctly.

To generate and submit claims:

1. Navigate to the Billing module and select Billing
2. Select the items that are being bulk-merged onto a claim, by clicking the checkbox  next to the claims
3. Click the Actions drop-down and select Bulk-merge claims
4. In Separated Claims View, the claims will be separated by client. Select the “Box 19” checkbox to auto-populate NPI numbers and providers’ first and last names from clients’ Claims Settings to Box 19 Notes in the CMS 1500 form.
   • Please note, the provider’s NPI number will be formatted as XX. There are no spaces between the NPI number and indicator, but there is a comma after the provider’s last name. See below for an example:
     • XXNPIProviderName 
       • XX123456789Smith, Mary 
   • If the provider’s last name is not presented in the client’s Claims Settings, the format will be in ten 9’s, plus the provider’s last name and first name. 
     • For example, 9999999999PSmith,Mary 
   • For multiple services with two different providers for the same claim, both providers’ information will be in Box 19 Notes in the format of NPI indicator, NPI number, provider last name, provider first name, followed by three spaces. 
     • For example: XXNPIProviderLastName, ProviderFirstName, XXNPIProviderLastName, ProviderFirstName 
       • XX9876543210Thomas,Mary  XX1234567890Smith,Mary 
   • If there are more than two distinct providers, Box 19 Notes will display the first two providers found in the service line sorted by last name.  
     • Please note:
       • If a provider does not have a first or last name in the contact’s Claims Settings, Box 19 in the CMS 1500 form will be blank.  
       • If the provider’s name is more than 20 characters, it will be truncated to 20 characters. 
       • Users can edit the Box 19 Notes field in the claim editor.
5. Review the following fields:
   
   
   • Diag Codes: If diagnosis codes are not listed, add diagnosis codes to the client’s profile or to individual authorizations.
   • Date: The date of service is not editable, as it comes directly from the timesheet
   • Service codes: Service codes are not editable in this view. To edit service codes, edit the timesheet or add service lines to the individual timesheet.
   • Pointer: Pointers can be added and edited on this screen by typing them in the four available fields.
     • Please note, if there are no diagnosis codes listed, pointers will not populate either.
   • Provider: The person who performed the services in the appointment and will populate in box 24J on CMS 1500 claims forms. 
     • To edit this field, click the search  icon and type the name of a provider.
     • Click the gear  icon to clear the provider and for “SYNC OPTIONS”
       • Please note, this edit only applies to the claim form. The system will not apply any changes to the schedule or payroll information.
     • If an employee does not populate in the search, the employee does not have Claims Settings set in their contact information.
     • Provider is editable because, when submitting, box 31 and the NPI should match the information being sent in box 24j and the line item NPI.
   • Payor: The payor associated with this service line. The payor can be edited in the timesheet in the Billing screen. 
   • Location: The service location address will populate in box 32 on CMS 1500 claims forms. The location can be edited in the timesheet.
   • Billing: The billing provider location information will populate in box 33 on CMS 1500 claims forms and is used to populate the EIN on claims. Generally, this is where checks need to be sent. The billing provider can be edited on the individual timesheet, in “Claim Info.”
     • Please note, Location and Billing are generally the same, unless you have multiple offices, tax IDs, or NPIs.
   • Referrer: The referring provider will populate in box 17 on CMS 1500 claims forms. To edit this field, click the search icon and type the name of a provider.
   • Provider Supplier: The rendering provider information can be found in box 31 on CMS 1500 claims forms. The Provider/Supplier can be edited on the individual timesheet, in “Claim Info.”
     • Please note, this information should match the information in Provider
6. Please note:
   • These fields are extracted from individual timesheet data. If they need to be corrected, edit the timesheet accordingly
   • Payor, Location, Billing, Referrer, and Provider Supplier need to have the same information in them. Otherwise, the system will not let you proceed
7. Claims can be submitted in Separated Claims View or Combined Claims View, depending on how you want to organize line data
   • In Separated Claims View, each timesheet is represented by a single line on claims forms.
   • In Combined Claims View, any timesheet items with the same date of service and an identical code are combined into one line for the claim. Units and summated dollars will appear on the same, singular line of the claim.
     
     
     • Please note:
       • CentralReach recommends submitting claims in Combined Claims View, so that insurance carriers do not flag line items as duplicates.
       • If using modifiers to delineate differences between unique services, uncheck Combine modifiers. Unchecking this will separate lines, as needed.
       • In order to bulk update a combined line with modifiers, “Combine Modifiers” must be checked.
8. Click Start claims generation and then click Go to claims inbox
   • Or, navigate to the Claims module and select Claims Manager
9. Correct any errors in the claim, if any. The number of errors in the claim can be found in the Errors column. To edit the claim:
   • Click the Actions drop-down on the right-hand side and select Edit
   • Fields with errors will be underlined in red and each tab will have a number next to it. Correct them accordingly
   • Click Save claim
     
10. Select the claims to be submitted by selecting the checkbox on the left-hand side of each claim
11. Click the Actions  drop-down and select Export/Download or Send to Gateway
    • Export/Download: allows data to be exported to a data file or CMS 1500 form. On CMS 1500 forms, data will be overlaid for mailing or faxing.
      • Please note, if the claim has over six submission lines on the CMS 1500 form, the system will split the claim data into multiple forms.
    • Send to Gateway: allows claims to be submitted electronically via a gateway, if a supported clearinghouse is being used.
      • Please note:
        • If the claim being sent electronically has over six submission lines, the data will be grouped together into “one” claim.
        • CentralReach recommends using gateways to submit claims, speed up payments and responses, and, if receiving 835/ERA files, simplify the AR reconciliation process of individual billing entries.

CentralReach offers the ability to receive responses (payments/rejections) from insurance companies electronically, via Office Ally.

To access your electronic responses:

1. Navigate to the Claims module and select Claims Manager
2. Click the Responses tab. To access only payments, click the Payments tab
3. Click the + to the left of the claim ID, to expand the payment information. Once the information has expanded, click the eye icon on the right-hand side to open the payment reconciliation page
4. Reconcile/post the electronic payments. Once the payments have been posted they will be reflected in the billing entries associated with them

When sending claims through the gateway, an error message will display if the insurance company’s payor ID is missing from a client’s insurance information and/or no plan has been selected.

If you receive this error while trying to send claims through the gateway in the Claims module, verify the information is missing by:

1. Navigating to the Claims module and selecting Claims Manager
2. Click on the payor listed on the claim you are trying to export
   • If the required information is missing, it will reflect in a pop-up box

Open a support ticket for one of our specialists to add a payor ID to your account.

To manually edit the provider/supplier within a claim:

1. Navigate to the Claims module and select Claims Manager
2. Locate the claim to be edited. Click the Actions drop-down on the right-hand side and select Edit
3. On the next screen, navigate to the Provider/Supplier tab
   

Please note, the information listed under “Last/Organization Name,” “First Name,” and “Provider Signature” will appear in box 33 of the CMS 1500 form. Also, if there is no signature on file for the given provider, the provider can manually sign the form after it has been printed.

When submitting a claim, the following information is needed to submit the paper CMS 1500 form to secondary insurance.

To populate claims with the appropriate information:

1. Navigate to the Billing module and select Billing
2. Click on the dashed line underlining the Payor and select the secondary insurance the claim is being submitted to under the drop-down menu
3. Click on the red checkmark to save
   
4. Select the billing entries to be submitted. Click the Actions drop-down and select Bulk Merge claims
5. Once changes have been finalized, navigate to Start claims generation and select Go to claims inbox. The secondary payor should now be listed as the payor, under the “Payor” column
6. To edit the claim, click the Actions drop-down on the right-hand side and select Edit
7. Under the COB tab, click the Choose Payer drop-down to select the primary payor as the “Other Insured.”  The information for the primary payor will populate automatically. However, additions and changes can be made to any missing pieces of information
   • Please note, make sure the first and last names are correctly entered and that what is listed under the “Policy/Group/FECA Number” is the primary insurance ID number.
     
8. To populate the amount paid by the primary insurance or other payor, under box 29 on the CMS 1500 form, click the Claim tab and enter the value under Amount Paid
9. Click Save Claim in the upper-right corner
10. The form is now ready to print. To print the form, navigate to the Claims module and select Claims Manager
11. Select the claim to be printed. Click the Actions drop-down, then select Export/Download, and check Ignore errors
12. Click Export
    
    
13. Click the Claims Export Progress window in the bottom-right corner and select download and Download in the “Download The File” pop-up
    
    
14. Open the PDF File
    

The information for the primary and secondary payors should already be in 9 and 1, respectively, with box 11d checked for Yes. The information in box 29 contains the amount already received. For example, if you received $0.00, enter that amount in.

Please note, once the payor information has been changed from the Billing screen, receivables will reflect the money owed by the secondary payor, not the primary payor.

When processing a claim within the Claims Manager, CentralReach will automatically combine lines of service with the same date and service code. This does not alter the original timesheets or billing entries, ensuring an accurate history for payroll and billing purposes.

To combine service lines automatically, start by generating a claim:

1. Navigate to the Billing module and select Billing
2. Click the  checkbox next to the billing entries to be submitted
3. Click the Actions drop-down and select Bulk-merge claims
4. Click the Combined Claims View tab to view all entries with the same billing code and date of service, combined into a single service line. 
5. Click the > to expand the “x codes to be billed” and then click on the blue +/- next to the service line to see the individual lines that were combined
   
6. Click the  icon next to individual billing entries to combine or un-combine service lines
7. When finished combining and un-combining, as required by the insurance company, click Start claims generation
   • The service lines will be combined in the Services tab on the claim

In the Claims Manager, users can manually alter claims and combine dates of service. This does not alter the original timesheets or billing entries, ensuring an accurate history for payroll and billing purposes.

To combine service lines manually, start by generating a claim:

1. Navigate to the Billing module and select Billing
2. Click the  checkbox next to the billing entries to be submitted
3. Click the Actions drop-down and select Bulk-merge claims
4. In the “Separated Claims View” tab, click Start claims generation and then Go to claims inbox
   
   
5. Click the Actions drop-down on the right-hand side and select Edit
6. Click the Services tab
   
   
7. Click the Add New drop-down under “Service Lines” and select Add Manual Line
8. Provide the claim information in the Details tab, the rendering provider information in the Rendering Provider tab, and the ordering provider in the Ordering Provider tab, if it differs with the rendering provider
   
   
   
   
9. Once complete, users can delete the other entries by clicking the  icon on the right-hand side of the billing entry

You can create and apply customized claim labels to better manage your claims.

To create claim labels:

1. Navigate to the Claims module and select Claims Manager
2. There are two ways to create a claim label:
   • The first is to click on a label  icon and then the gear icon

• The second way is to pull up the sidebar menu by clicking on the funnel  icon to the left, then clicking the gear  icon next to My Claims Labels

3. From the pop-up, select Add new label from the Choose Label drop-down. Type the name of your label, add an optional parent label to house it within a “folder” of labels, and select an optional color scheme. When finished, click Create label

• Examples of label names: Claim not billed, Rework claim, Claim denied, Claim requires additional data, etc.

4. To apply the label to an individual claim, click on the label  icon and type in the name of the label you want to add. Then select it from the drop-down menu. The label will be applied to the claim and you can now use the label in the search field

5. You can also bulk apply/remove labels by checking the boxes next to them to the left, and clicking on Label Selected. Add labels to the Apply Labels box and then click Apply Label Changes