Claims Processing

3 ways electronic transactions can help manage payment errors


Practices that have made the transition from paper to an electronic claims revenue cycle spend less time on administrative processes and have more time to ensure correct payment and appeal inappropriate denials. Learn how to make this transition in your practice.

More practices are improving their revenue cycle by accepting electronic remittance advice (ERA), an electronic version of a paper explanation of payment. The benefits of using ERAs are many, and a major one is having an easier time identifying payment errors. A free webinar gives you what you need to know about effective use of the ERA transaction, processing tips and other resources.

View the webinar to understand how ERAs can help you manage payment errors in your practice in these three ways:

  • The ERA’s class of contract code can identify the specific contract or fee schedule that applies to a claim. Then, compare the allowed amount to the fee schedule to validate discrepancies and appeal to the payer.   
  • The ERA allows multiple processes for reporting overpayments and includes information to ensure your practice management system can automatically track reported overpayments and payers’ recovery of overpaid amounts.   
  • Using ERA with electronic funds transfer (EFT) can let you further automate your revenue cycle. When your practice management system tracks both ERAs and EFTs, practice staff won’t need to manually match and post them. Instead, they can focus on missing ERAs or EFTs, which represent exceptions or errors.
  • The AMA’s newly updated ERA toolkit gives insight into questions you should ask insurers, billing services and practice management system vendors before making the switch from paper explanations of payment.  
  • Use the AMA’s Claims Workflow Assistant to understand your ERA transactions and determine whether your claims have been processed properly by insurers. If you determine that there is an issue with a claim, you should consider submitting an appeal letter. AMA members can use these sample appeal letters to get started.   
  • Access additional resources for assistance in navigating the claims process, from selecting a practice management system to dealing with overpayment disputes.
  • How to handle overpayment recovery requests
  • Tips for providing point-of-care pricing
  • Ways to refine your patient payment management process