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Electronic Remittance Advice (ERA) Toolkit

Electronic remittance advice (ERA) is a  transaction that provides an electronic version of an explanation of payment and contains  detailed information regarding a provider's adjudicated claim.  Transitioning to ERA can provide numerous benefits for physicians, including:

  • Easier payment reconciliation;
  • Reduced time spent on manual processes such as opening mail, filing, and phone calls to health insurers;
  • Elimination of lost explanations of benefits (EOBs) / explanations of payments;
  • Expedited filing of claims to secondary payers; and
  • Enabling the focus of practice staff time on revenue-enhancing functions such as ensuring correct payment.

 

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AMA resources on transitioning to ERA

ERA Toolkit:  The AMA's ERA Toolkit features multiple resources designed to help physicians understand and consider the transition to the ERA process.

Webinar:  Learn more about ERA and electronic transactions by watching "Save with Electronic Remittance Advice".

EFT Toolkit:  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.

Tools for understanding and appealing claims remittance information

Claims Workflow Assistant:  Check out the AMA's Claims Workflow Assistant, a resource designed to assist physician practices in understanding the codes and contents of ERAs and other health plan payment remittance information.

Appeals Letters:  The AMA has a series of letter templates that AMA members can use to appeal health plan payment edits and to address payment concerns with health plans and patients. 

Remittance code information: 

  • Consult additional information from the Washington Publishing Company website about the Claim Adjustment Reason Codes (CARCs) and Remittance Advice Remark Codes (RARCs), which are the standard codes used in ERA transactions. 
  • Accredited Standards Committee (ASC) X12, a standards development organization for electronic information exchange that develops the electronic transaction standards, has released a Type 2 Technical Report (TR2) identifying usage standards for CARCs and RARCs conveyed in ERA transactions, which is available for purchase through their website.

Other ERA resources

CMS Resources

  • Medicare Remit Easy Print (MREP) software allows physicians and other health care providers to view and print ERAs and additional information related to Medicare payments.
  • CMS education on ERA/EFT: Learn how operating rules for EFT/ERA can speed up payment in your practice by consulting a CMS publication offering guidance on ERA/EFT.

ERA Operating Rules
The ERA operating rules, developed by Council for Affordable Quality Healthcare Committee on Operating Rules for Information Exchange, are the necessary business rules and guidelines for ERA that are not defined by the regulation or implementation guide.