Electronic Remittance Advice (ERA) Toolkit
6,200 average claims submitted annually=nearly $10,000 in savings!
Want to save nearly $10,000 per physician annually?* Use this toolkit to learn how to use electronic remittance advice (ERA): " An electronic version of a payment explanation which provides details about providers' claims payment."** Accepting ERA and automating your claims process can:
• Speed up payment
• Save time spent on manual processes such as opening mail, filing and phone calls to health insurers
• Eliminate lost explanations of benefits (EOBs) and expedite filing to secondary payers
• Free time for revenue-enhancing functions such as ensuring correct payment
Cost of handling paper EOBs: $2.96 x 6,200 = $18,352
Cost of handling electronic remittance advice: $1.48 x 6,200 = $9,176
Average annual savings from remittance automation per physician: ≈$9,176*
* Based on an annual average of 6,200 remittances for a single physician. Source: Milliman, Inc., Electronic Transaction Savings Opportunities for Physician Practices. Technology and Operations Solutions. Revised: January 2006
** Source: CAQH Committee on Operating Rules for Information Exchange (CORE) Phase III CORE EFT & ERA Operating Rule Set, June 2012
Easily print all of the ERA toolkit resources together that are listed below.
- "Considerations for processing electronic transactions in the physician practice" offers specific scenarios of how you practice might adopt electronic transactions, and provides additional considerations for your specific situation.
- Key questions to ask your vendors
- Learn more about ERA and electronic transactions by watching the archived webinars, Save with Electronic Remittance Advice and Beyond the Claim: HIPAA 5010 Administrative Simplification Opportunities to Positively Impact your Revenue Cycle Management
- ERA and electronic funds transfer (EFT) work hand in hand to streamline remittance and payment processes. Access the AMA's EFT toolkit to learn more about using the EFT transaction.
- The suite of electronic health care transactions are designed to work together to create greater efficiences for both physicians and health insurers. By adopting an integrated approach to using the electronic health care transactions, information gained from one transaction becomes useful information in the next transaction. Learn more about the potential savings and access a detailed case study.
- Access the AMA resource “Understanding the HIPAA standard transactions: The HIPAA Transaction and Code Set rule"; for an overview of electronic healthcare transactions.
- Streamline your claims process even more. Access toolkits and archived webinars to help your practice use all the electronic transactions.
A new reporting tool from the AMA can help your practice identify the cost of processing claims with seven of the nation’s largest commercial health insurers. The AMA’s Administrative Burden Index provides scores on claims-processing measures for the commercial health insurers included in the AMA’s sixth annual National Health Insurer Report Card. Your practice can use this index when determining their practice automation priorities and in conjunction with contracting.
Medicare Remit Easy Print (MREP) Software allows physicians and other health care providers to view and print as many of as few electronic remittance advices (ERA) as needed. This FREE software can save you time resolving Medicare claim issues by providing the following functionalities:
- Navigation and viewing of the ERA using your personal computer
- Print the ERA in the Medicare standard paper remittance advice format
- Search capability that allows providers and suppliers the ability to find claims information easily
- Print and export reports about ERAs including denied, adjusted, and deductible applied claims
- Archive, restore, and delete imported ERAs
For further information and to download MREP software, refer to the Medicare Remit Easy Print section of the CMS website.
- HHS operating rules for ERA: The U.S. Departmemt of Health and Human Services (HHS) has adopted (August 10, 2012) a set of operating rules for electronic remittance advice (ERA) and the usage of related code lists (allowing for automated reconciliation with the remittance advice) (Sec. 1104). The healthcare ERA operating rules are effective January 1, 2014, as well as the EFT operating rules.
- CMS education on ERA/EFT: Learn how operating rules for EFT/ERA can speed up payment in your practice! View education from CMS about ERA/EFT for guidance and tips on ERA/EFT enrollment and usage. This resource will also help your practice understand how HIPAA mandates the consistent and uniform use of Remittance Advice (RA) codes [Group Codes, Claim Adjustment Reason Codes (CARC) and Remittance Advice Remark Codes (RARC)] to handle claims denials and streamline the claims revenue cycle process.
- CAQH CORE operating rules for ERA: The usage of standard codes and messages within the HIPAA ERA enhances the ability for a vendor or practice to establish rules for automated posting when appropriate and manual intervention when necessary. Standardization is enhanced further by the mandated CORE Operating Rules for code usage, which provide usage guidance for the creators of the ERA as well as those displaying ERA information to practice staff. Learn more about Claim Adjustment Reason Codes (CARCs) and Remittance Advice Remark Codes (RARCs) and ERA operating rules