Electronic Remittance Advice Toolkit
6,200 average claims submitted annual=nearly $10,000 in savings!
Want to save thousands of dollars per physician annually? Accepting electronic remittance advice (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 EOBs and expedite filing to secondary payers
• Free time for revenue-enhancing functions such as ensuring correct payment
Cost of paper EOBs: $2.96 x 6200 = $18,600
Cost of electronic remittance advice: $1.48 x 6200 = $9,176
Annual savings from claims automation per physician: $9,424*
* Based on an annual average of 6,200 claims submitted for a single physician. Source: Milliman, Inc., Electronic Transaction Savings Opportunities for Physician Practices. Technology and Operations Solutions. Revised: January 2006
Calculate your potential savings: View Aetna’s EDI savings calculator
By eliminating significant parts of the manual processes in an office’s routine, physicians can free their practice staff to perform other revenue-enhancing functions. Access the following educational resources “Information technology solutions: consider the potential savings” and determine your practice’s potential savings.
Access the AMA resource “Understanding the HIPAA standard transactions: The HIPAA Transaction and Code Set rule” for an overview of electronic healthcare transactions.
Medicare Remit Easy Print (MREP) Software
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.
- Beyond the Claim: HIPAA 5010 Administrative Simplification Opportunities to Positively Impact your Revenue Cycle Management
- Electronic Remittance Advice
Take the brief Health Insurance Portability and Accountability Act (HIPAA) Transaction Code Set Vendor Survey to easily find out whether your vendors can process electronic claims and other healthcare transactions.
Visit 5010 electronic administrative transactions for more information on assessing 5010 readiness.
“Considerations for processing electronic transactions in the physician practice” offers specific scenarios of how your practice might adopt electronic claims submissions, and provides additional considerations for your specific situation.
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.
Visit www.ama-assn.org/go/payerpolicies to access online resources from health insurers to help you move towards practice automation.
The suite of electronic health care transactions are designed to work together to create greater efficiencies 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.
- Did you know that the increased use of electronic health care transactions in your practice, such as the electronic eligibility benefit inquiry and response transactions, has the potential to save physicians and health insurers nearly $30 billion per year? [1]
Access this case study to learn more about the savings your practice can experience using electronic health care transactions.
[1] U.S. Healthcare Efficiency Index, www.ushealthcareindex.com
“Questions to ask a health insurer before enrolling in an electronic transactions program” outlines key issues with using electronic claims submissions that you need to carefully consider.
“Questions to ask a billing service before enrolling in an electronic transactions program” provides key questions to discuss with your billing service to understand how it can assist you in using electronic claims submissions.
“Questions to ask a clearinghouse before enrolling in an electronic transactions program” provides key questions to discuss whether your clearinghouse provides satisfactory functionality for electronic claims submissions.
Use the Health Insurance Portability and Accountability Act (HIPAA) complaint form to inform the AMA about health insurers and other payers that are out of compliance with the HIPAA electronic transaction and code set standards.
