Resolving Encounter-Related ERA Errors

ERA Message	Resolution
Line item transaction successfully posted	Not applicable.
Encounter Not Found	You must manually post this ERA claim payment from the EOB.
Patient policy nbr does not match the reported nbr from the payer	You can compare the patient HIC policy number that is reported from the ERA file to the number entered on theInsurance Maintenancewindow.
Payer/Insured combination not found within this encounter	You can use the insured's policy number to determine which number the discrepancy is with. You can compare the patient HIC policy number listed at the end of the ERA message to the insured's policy number associated with the encounter. You can get the insured's policy number from theInsurancetab on the patient chart. If the insured's policy numbers match, the problem is with the payer's ERA number. You can contact Client Services to have the payer set up in your application, to receive ERA.
Not posted due to ineligible Policy Number	You must manually correct the policy number.
Multiple encounter payers are matched with the exact policy number <policy number>	You must manually edit the policy number in the encounter.
Line item is not posted - Post to void charge option is disabled in Remittance Profile Library.	You must enable thePost to voided chargeoption from the payer- or practice- level Remittance Profile Library.
Encounter payer not found. Tertiary payer does not exist in the encounter.	To post the transaction, you must add a tertiary payer in the encounter.
Multiple payments found for the same line item.	You must enablePost Unbundled Payment to Single Chargeoption in Remittance Profile Library.

Help Guide for NextGen® Enterprise PM 8

Resolving Internal System-Related ERA Errors

The ERA messages outlined here are related to internal system errors. These ERA messages are also considered primary and secondary. The primary error ERA message This type of ERA message indicates the exact line item in the encounter that caused the ERA posting process for the encounter to be unsuccessful. The secondary ERA message This type of message displays for any line item following the primary error. Because the ERA posting process was stopped due to the primary error, these line items are not processed. The following table outlines each of the primary error ERA messages and the associated secondary ERA messages, a description of why the primary and secondary ERA message may have occurred, and the possible resolution to the primary error message. Primary Error ERA Message Message Description How to Resolve Insurance not found for this encounter. The ERA file information for the insurance associated with this encounter does not match the insurance associated with the encounter in

Help Guide for NextGen® Enterprise PM 8

Bundled Payments

For bundled payments, the ERA Import Posting report functions as described below: If an Encounter Level Payment Distribution method is not selected in the Remittance Profile library, the ERA Import Posting report displays the following message: "Bundled payment was not posted because Encounter Level Distribution method was not enabled in the Remittance Profile". Note: The ERA Posting process cannot post bundled payments unless an Encounter Level Payment Distribution method has been selected in the Remittance Profile. If the claim is UB/837I and no claim was found for the encounter of the NU bundled payment, the ERA Import Posting report displays the following message: "Bundled payment was not posted because no claim was identified for this encounter". If the claim is UB/837I and no match was found for the NU bundled payment, the ERA Import Posting report displays the following message: "Bundled payment was not posted because no charge match was found for this revenue code". If the clai

Help Guide for NextGen® Enterprise PM 8

Resolving Encounter-Related ERA Errors

The following table describes the ERA messages related to the encounter information, and not just a particular line item in the encounter. The ERA message that is associated with the encounter appears next to every line item in the encounter that is reported on the ERA Import Posting report. ERA Message Resolution Line item transaction successfully posted Not applicable. Encounter Not Found You must manually post this ERA claim payment from the EOB. Patient policy nbr does not match the reported nbr from the payer You can compare the patient HIC policy number that is reported from the ERA file to the number entered on the Insurance Maintenance window. Payer/Insured combination not found within this encounter You can use the insured's policy number to determine which number the discrepancy is with. You can compare the patient HIC policy number listed at the end of the ERA message to the insured's policy number associated with the encounter. You can get the insured's policy number from t

Help Guide for NextGen® Enterprise PM 8

Resolving Internal System-Related ERA Errors

The ERA messages outlined here are related to internal system errors. These ERA messages are also considered primary and secondary. The primary error ERA message This type of ERA message indicates the exact line item in the encounter that caused the ERA posting process for the encounter to be unsuccessful. The secondary ERA message This type of message displays for any line item following the primary error. Because the ERA posting process was stopped due to the primary error, these line items are not processed. The following table outlines each of the primary error ERA messages and the associated secondary ERA messages, a description of why the primary and secondary ERA message may have occurred, and the possible resolution to the primary error message. Primary Error ERA Message Message Description How to Resolve Insurance not found for this encounter. The ERA file information for the insurance associated with this encounter does not match the insurance associated with the encounter in

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

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

Resolving Encounter-Related ERA Errors

Recommendations

Resolving Internal System-Related ERA Errors

Bundled Payments

Resolving Encounter-Related ERA Errors

Resolving Internal System-Related ERA Errors

Posting an Electronic Remittance

Posting an Electronic Remittance

Resolving Encounter-Related ERA Errors

Resolving Internal System-Related ERA Errors

Bundled Payments

Resolving Encounter-Related ERA Errors

Resolving Internal System-Related ERA Errors

Posting an Electronic Remittance

Posting an Electronic Remittance