Reversals and Corrections Tab - Options and Settings

Option	Description
Reversals and Corrections These options define business rules for ERA reversal and correction transactions imported into NextGen® Enterprise PM.
Do not post adjustments that increase the balance (negative adjustments)	Prevents negative adjustments that will increase a balance from being posted and added to the batch when the ERA file is processed. They display on the ERA Import Posting report as “Not Posted”. This allows you to follow-up to ensure the adjustment amounts are correct.
Do not post reversals (negative payments)	Prevents negative payments that will increase a balance from being posted and added to the batch when the ERA file is processed. They display on the ERA Import Posting report as “Not Posted”. This allows you to follow-up to ensure the payment amounts are correct.
Force line item credit balances from a corrected payment	Determines whether reversal or correction payment transactions that will create line item credit (negative) balances should be posted and added to the batch when the ERA file is processed. If enabled, then a reversal/correction payment transaction that results in a line item credit balance will be posted. It displays on the ERA Import Posting report as "Line Item Successfully Posted". If not enabled, then a reversal/correction payment transaction that results in a line item credit balance will not be posted. It displays on the ERA Import Posting report as “Line Item Not Posted due to a reversals and corrections setting”.
Write off balance resulting from either Overpayment or Underpayment These options define business rules for writing off balances resulting from ERA reversal and correction transactions imported into NextGen® Enterprise PM.
If corrected payment results in a negative balance (-)	Writes-off a negative (credit) line item balance that was created by a reversal/correction payment transaction. The balance will be adjusted to $0.00.
Transaction Code	If allowing negative balances created by reversal/correction payment transactions to be adjusted to $0.00, select the third-party Transaction Code to be used. If a transaction code is not selected, then the code defined in the Write Off Remaining Payer Balance field in Practice Preferences > Transactions will be used.
If corrected payment results in a positive balance (+)	Writes-off a positive (debit) line item balance that was created by a reversal/correction payment transaction. The balance will be adjusted to $0.00.
Transaction Code	If allowing positive balances created by reversal/correction payment transactions to be adjusted to $0.00, select the third-party Transaction Code to be used. If a transaction code is not selected, then the code defined in the Write Off Remaining Payer Balance field in Practice Preferences > Transactions will be used.
Set transaction status to 'NONE' for non-zero balances	Sets the Transaction Status on line items with a non-zero balance (positive or negative) that was created from a reversal/correction payment transaction to None. This keeps the balance with the current payer from which the reversal/correction payment was received.

File Maintenance Help for NextGen® Enterprise 8

Set Up the Remittance Profile - Reversals and Corrections Tab

The Reversals and Corrections tab in the Remittance Profile library is used to set options for handling the following types of ERA transactions: Reversals and Corrections Writing Off Balances resulting from Overpayments or Underpayments To set up the Reversals and Corrections tab in a Remittance Profile library, do the following: Open File Maintenance. Select Libraries, and then select Remittance Profiles. The Remittance Profiles List window opens. Open the profile library. The Remittance Profile window opens. Select the Reversals and Corrections tab. Select settings for reversal and correction options. For more information, see Reversals and Corrections Tab - Options and Settings. When you're done setting options, select OK to save changes and close the window. Reversals and Corrections Tab - Options and Settings Parent topic: Remittance Profiles Library

Help Guide for NextGen® Enterprise PM 8

Reversals and Corrections Tab - Options and Settings

You can use the following list of options and descriptions to make settings on the Reversals and Corrections tab in your Remittance Profile. Option Description Reversals and Corrections These options define business rules for ERA reversal and correction transactions imported into NextGen® Enterprise PM. Do not post adjustments that increase the balance (negative adjustments) Prevents negative adjustments that will increase a balance from being posted and added to the batch when the ERA file is processed. They display on the ERA Import Posting report as “Not Posted”. This allows you to follow-up to ensure the adjustment amounts are correct. Do not post reversals (negative payments) Prevents negative payments that will increase a balance from being posted and added to the batch when the ERA file is processed. They display on the ERA Import Posting report as “Not Posted”. This allows you to follow-up to ensure the payment amounts are correct. Force line item credit balances from a correct

Help Guide for NextGen® Enterprise PM 8

Reading the ERA Import Posting Report

After you have completed the ERA Posting process, the ERA Import Posting report generates. Overall, the report is a complete audit of the ERA 835 file and is grouped by unsuccessful and successful entries. NextGen® Enterprise PM does not, however, report provider level adjustments. The report is sorted by practice with the ERA payments that did not post successfully listed first, followed by all the ERA payments that posted successfully. An ERA message displays in the Description column of the report next to each line item as an indicator for why the ERA claim payment did or did not post against the encounter information. Each of these messages applies to ANSI file formats. The transaction level Reason Codes that are distributed to service lines display on the report, along with their descriptions. Note: The ERA Import Posting report detects and rejects an ERA transaction with a denial reason code and total transaction amount that is not $0.00. Resolving Encounter-Related ERA Errors On

Help Guide for NextGen® Enterprise PM 8

Set Up the Remittance Profile - Reversals and Corrections Tab

The Reversals and Corrections tab in the Remittance Profile library is used to set options for handling the following types of ERA transactions: Reversals and Corrections Writing Off Balances resulting from Overpayments or Underpayments To set up the Reversals and Corrections tab in a Remittance Profile library, do the following: Open File Maintenance. Select Libraries, and then select Remittance Profiles. The Remittance Profiles List window opens. Open the profile library. The Remittance Profile window opens. Select the Reversals and Corrections tab. Select settings for reversal and correction options. For more information, see Reversals and Corrections Tab - Options and Settings. When you're done setting options, select OK to save changes and close the window. Reversals and Corrections Tab - Options and Settings Parent topic: Set Up a Remittance Profile Library

Help Guide for NextGen® Enterprise PM 8

Posting an Electronic Remittance

This section provides information about the process of posting an electronic remittance. When posting the ERA, the system compares the ERA payment information for each claim in the file against the encounter information in your system that the claim was originally created for. In order for the ERA payments for each claim to post successfully, the ERA payment information for a claim must match the encounter information the ERA is posting against. If there is a discrepancy between the ERA information and the encounter information, the ERA payment for that claim does not post and an error message displays on the ERA Import Posting report. In addition, if an ERA payment is posting against multiple line items in an encounter, all the line items must be error-free for the ERA payment to post successfully. The ERA process only calculates and posts adjustments for encounter primary and secondary payers. If the primary ERA pays a charge off, it is settled to the secondary and is included on the

Help Guide for NextGen® Enterprise PM 8

Electronic Remittance Advice

Electronic Remittance Advice (ERA) 835 files can be imported from the File > Processes > ERA Posting menu. This process compares transactions in the ERA 835 file for each claim against the charge information in NextGen® Enterprise PM. When ERA transactions match to charges, a transaction batch is automatically created, and the ERA transactions are added to the batch ledger. Transactions in the ERA file that do not match to charges, or do not post for other reasons, display on the ERA Import Posting report as “Not Posted” and are not added to the transaction batch. The ERA Posting process is designed to increase efficiency. Once the original set up for the process is complete, there is minimal effort required to set up additional payers. It is estimated to take about 15 minutes to post an electronic ERA 835 file for a 30-page Explanation of Benefits (EOB) electronically, compared to approximately two hours to post the same 30-page EOB manually. ERA Automatic Adjustments and Library Sett

Reversals and Corrections Tab - Options and Settings

Recommendations

Set Up the Remittance Profile - Reversals and Corrections Tab

Reversals and Corrections Tab - Options and Settings

Reading the ERA Import Posting Report

Set Up the Remittance Profile - Reversals and Corrections Tab

Posting an Electronic Remittance

Electronic Remittance Advice