If you have successfully enrolled with payer, all Electronic Remittance Advice (ERAs) are automatically imported into PatientStudio.
ERA Statuses
Each ERA is assigned a status based on claim posting progress:
Open – None of the claims in the ERA have been posted.
Pending – Some claims have been posted, but not all.
Closed – All claims have been posted, or no further posting is needed.
ERA Mapping
PatientStudio automatically maps many adjustment codes to their respective financial transactions, ensuring accurate payment and adjustment postings.
For a breakdown of available transaction types and how they affect balances, refer to this article
Post an Auto-Mapped ERA
Post an Auto-Mapped ERA
Most ERAs will map payments and adjustments automatically
How To Post EOB From Patient Studio
1. Click "Billing"
2. Click "ERAs"
3. Click the ERA's Check Number
4. Click to drill into charge details
5. Click to drill into adjustment codes and payment mapping details
6. Common adjustment codes such as CO-45 will automatically map to the proper posting transaction.
7. You can always change the posting transaction by click the drop down and selecting a new transaction type.
8. Click "Post EOB"
9. Click "Post"
10. The green check mark will indicate this ERA was posted.
Post an ERA that Requires Payment Mapping
Post an ERA that Requires Payment Mapping
In certain scenarios the user/biller will need to make a decision on which posting transaction type is most appropriate.
1. This will be indicated by the Red "Payment Mappings Needed"
2. Click to view charge level details
3. Red rows will indicate payments that need mapping
4. Click the "^" icon.
5. Adjustment codes that cannot be automatically mapped will appear in red
6. Click "Action Required"
7. Select the appropriate transaction type
8. Click "Post EOB"
9. Click "Post"
10. To view the claim, click the DOS
11. In this scenario the $25.48 was moved from insurance balance to the patient balance.
12. As a result the claim status has moved to "Patient Responsibility"
Post a Medicare ERA that has a supplemental payer
Post a Medicare ERA that has a supplemental payer
Medicare supplemental plans have a unique workflow
1. If a secondary insurance is present in the patient's profile, "Forward to Secondary" will appear on the posting modal.
2. Click "Post EOB"
3. Click "Post"
4. Click the DOS to view the claim
5. Notice the primary claim is closed. Click "Secondary Claim"
6. The secondary claim was automatically created based on the patient responsibility from the primary ERA
7. Because Medicare forwards remittance to the supplement plan, the secondary claim automatically moves to "Accepted by Payer"
Post a Commercial ERA that has a secondary payer
Post a Commercial ERA that has a secondary payer
1. From the ERA screen: If a secondary insurance is present in the patient's profile, "Forward to Secondary" will appear on the posting modal.
2. Click "Post EOB"
3. Click "Post"
4. Click the DOS to view the claim
5. The primary claim was closed. Click "Secondary Claim"
6. The secondary claim was automatically created and set to "Ready To Bill"
7. To submit this claim, click "Claim Actions"
8. Click "Submit claim"
9. Click "Submit"
10. Click "Close"
