Remittances

An electronic remittance (ERA, or 835) is the payer's statement of what it paid on each claim and why. Remittances arrive from the clearinghouse on their own. Open Remittances under Payments in the Billing panel of the main menu.

How a remittance posts#

For each claim in a remittance, NeatPractice:

1. finds your claim by its claim number, the payer's claim number, or the patient, dates and services;
2. matches each service line to your charge;
3. checks that the amounts balance and that every adjustment code has a posting rule;
4. posts the payment, the write-offs and the moves to the next payer or the patient.

A claim that passes every check posts on its own (Auto-posted). Any other claim waits in ERA exceptions.

Import a file#

When a payer gives you an 835 file directly, choose Import 835 and pick the file. It is handled the same way as one from the clearinghouse. A file that was already imported is skipped and nothing posts twice: the dialog says so and Open Original Remittance opens the first copy. Check Clearinghouse asks for new remittances now instead of waiting. Both need permission to manage remittances.

Open a remittance to see its claims and what happened to each, its payer-level amounts and its details. Print makes a PDF of the remittance; Download 835 gives you the original file.

ERA settings#

Choose ERA Settings in the header to turn automatic posting off or on for the whole clinic. When it is off, every remittance claim waits in ERA exceptions. To review one claim's remittances every time, open a remittance claim for it and choose Always Review This Claim. Days to wait for the bank deposit sets when an EFT remittance with no matching bank deposit shows up in the bank deposit exceptions. Variance tolerance ($) and Variance tolerance (%) set how far a payer's allowed amount may stray from the expected allowed before the line lands on Payment variances.

A remittance a bank deposit has paid shows Funded in the list.

ERA exceptions#

The ERA exceptions page lists the remittance claims that need a person, the oldest first, with why each one stopped: no matching claim, an unmatched line, amounts that do not balance, a code without a posting rule, a denial, a payer reversal or a takeback. Filter by status, reason or payer. Open one and:

• choose Link Claim to pick the claim it pays when none matched;
• choose Post to decide what each adjustment code does (write off, move to the next payer or the patient) and post it. A code the posting rules sent to review starts blank; pick its action before posting, so nothing is written off by default;
• choose Mark Handled with a note when nothing should post, for example when you posted it by hand.

You need permission to post insurance payments.

Payer suspense#

Some amounts belong to the whole remittance, not a claim: a recoupment of an earlier overpayment, a forward balance or interest. They keep the remittance's deposit balanced and wait on the Payer suspense page, which opens on Open items; change or remove the status filter to find resolved ones with their notes. Choose Link Claim to say which claim a recoupment takes money back from; type a claim number or patient name to search that payer's claims at every location you can reach. A recoupment or forward balance can be resolved only once its claim is linked. Resolve shows the payer, amount and linked claim before you confirm. For a linked recoupment, turn on Post the takeback against the claim to reverse that much of the payer's payment on the claim. When the payer's payments on that claim cover less than the recouped amount, nothing is posted and the item stays open: link it to the right claim, or resolve it without posting the takeback.