When an insurance payer sends you payment for a claim submitted electronically, the insurance payers generates an  electronic remittance advice (ERA) file containing details on payments and adjustments. DrCloudEHR scans the file and posts the payment and adjustment details to the DrCloudEHR payment system.

Automatically Process Electronic Remittance Advice (ERA) Payments

If an insurance payer processes claims through a clearinghouse, the company sends ERA files to the clearinghouse. DrCloudEHR downloads the ERA files from the clearinghouse on a scheduled basis. The application scans each file and automatically posts the payment and adjustment details to the DrCloudEHR payment system. No additional action is required on your part.

You must configure connections to the clearinghouse to automatically download ERA files. For more information, see Enable Electronic Payment Notifications.

Manually Process Electronic Payments

If an insurance payer does not send ERA files through a clearinghouse, you might need to download the files directly from the insurance company. You can then manually upload the files from a local directory on your computer to DrCloudEHR. 

Due to the amount of data being processed, the ERA process runs in the background, so that you can continue to use DrCloudEHR while the process runs. The application sends you an email when the process completes, and generates pa report in .html format that provides details on the results.

Note: You must configure your web browser to allow popup windows to post and process ERA files.

1. Click the Billing tab.
2. Click Payments in the left-hand navigation menu.

3. Click the ERA Posting tab in the Payments/Refunds page.
   

4. Start typing the name of the insurance company, and then select the company.
5. Click Choose File to upload the ERA file.
6. Click Process ERA. A pop up window listing the check numbers in the file displays.
   
7. Select the checkbox for each check you want to include.
   
8. Click Process. The ERA process runs in the background. 
9. Click Offline Processed ERAs or Offline Reports to view the processing status.
   When the process completes, click the icon under Download/View to download a .zip file containing the report in .html format.

View ERA Processing Reports

You can view reports that contain the details of ERA files processed by DrCloudEHR. You might want to view the report for a claim submitted for an encounter that the application is unable to reconcile.

1. Click the Billing tab.
2. Click ERA Process Report in the left-hand navigation menu.
3. Enter your search criteria.
4. Click Search. The details for processed ERA files loads in the table below.
5. Click the plus symbol icon next to an ERA entry in the table to view a summary of the ERA data.
   
   
6. Click the arrow icon in the ERA File column to download the original electronic data interchange file generated by the clearinghouse in .edi format. 
7. Click the icon in the Results column to load the contents of the electronic data interchange file in the window.
   
   The results provide you with options for investigating issues in the payment, as well as methods for notifying others if any actions are needed.
   • Click the View Encounter Forms icon in the Invoice column to view the details for the encounter the payment is for.
   • Click the Adjustments icon to view claim details in the Statement Manager, including any adjustments made.
     You can update the claim details with any payments made and reconcile the claim.
   • If the provider needs to address the issue, click the Send Message icon to send the provider an email.
   • To assign a task to the provider, click the Send Reminder icon.