ERA Posting Process

Help Guide for NextGen® Enterprise PM 8

Start the ERA Posting Process

The Electronic Remittance Advice (ERA) Posting process is not automatic. You must start it from the Import Remittance window. Note: The ERA Import function uses the CLP02 element to determine which COB to use if both primary and secondary payers have the same ERA Payer Number. The Default for Contract <> Payment Allowed Amount and Default for Contract <> ERA Payment Amount options are applicable only for the primary payer (CLP02=1). Note: You must create and assign an automated Encounter task in Task Types master file in File Maintenance along with the custom user-defined reason code to track the discrepancy in ERA payment amount and contractual reimbursed amount when 835/ERA file is posted in NextGen® Enterprise PM. For more information about creating and assigning the automated task, go to NextGen Healthcare Success Community and download the latest File Maintenance Master Files Guide for NextGen® Enterprise From the File menu, select Processes, and then ERA Posting. The Import Remit

Help Guide for NextGen® Enterprise PM 8

Preparing for the ERA Posting Process

Prior to ERA posting, you need to complete certain pre-requisites in preparation for the ERA posting process. The summarized list of processes to be completed in preparation for ERA are: Enroll for ERA with a trading partner (clearinghouse or payer). Complete the following setup in File Maintenance for ERA posting: Remittance Profile Library Reason Codes Library Payers Master File Payers-Alt Payers Master File Enterprise Preferences Practice Preferences Create a network directory and folder filing structure for ERA 835 files that can be accessed by all users who download/import files. For example: ServerName:\ERA\Medicare ServerName:\ERA\Medicare\Unprocessed_Files ServerName:\ERA\Medicare\Successful_Files ServerName:\ERA\Medicare\Partially_Processed_Files ServerName:\ERA\Medicare\Failed_Files ServerName:\ERA\Medicare\Reports Determine the naming convention to be used for ERA 835 files and reports. Consult with the trading partner for downloading files from their website. Download an ER

Help Guide for NextGen® Enterprise PM 8

ERA Posting Process

You must follow the steps to prepare for Electronic Remittance Advice (ERA) and the process for importing ERA 835 files received from a trading partner, such as a clearinghouse or payer, into NextGen® Enterprise PM. Note: You can now successfully import more than 500,000 single or multiple large ERA files, with or without Microsoft® Excel reports, in a short time. Preparing for the ERA Posting Process You must complete certain pre-requisites before ERA posting. Start the ERA Posting Process You must start the Electronic Remittance Advice (ERA) Posting process from the Import Remittance window. Posting an Electronic Remittance Parent topic: Electronic Remittance Advice

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

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

Help Guide for NextGen® Enterprise PM 8

ERA - 835

This section explains the ERA 835 file. The basic steps in working with the 835 file include: Download the file from the payer or clearing house. Set up an ERA Remittance Profile library. Select File > Process > Import ERA. Print the report. Verify the batches. Post the batches. Reference: For more information on the ERA 837 files, go to the NextGen Healthcare Success Community and download the latest Electronic Remittance Advice (ERA) User Guide for NextGen® Enterprise PM. Parent topic: Coordination of Benefits Electronic and Manual Processing

ERA Posting Process

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ERA - 835