Electronic remittance advice

Electronic Remittance Advice (ERA) is a digital version of a paper-based Remittance Advice, providing details about a payment made by a Health Insurance company, either directly to a patient or to a healthcare provider. It is an important part of the Healthcare Revenue Cycle Management.

Overview

The Electronic Remittance Advice (ERA) is an electronic document that provides detailed information about the amounts being paid by health insurers for healthcare services provided to patients. It is a critical component of the healthcare revenue cycle, as it allows healthcare providers to track payments and reconcile their billing records.

Function

The ERA provides detailed information about the amounts being paid by health insurers for healthcare services provided to patients. This includes the original billed amount, the allowed amount, the patient responsibility amount, and the payment amount. The ERA also provides information about any adjustments or denials made by the insurer.

Benefits

The use of ERAs offers several benefits over traditional paper-based remittance advices. These include:

• Efficiency: ERAs are typically delivered electronically, reducing the time and cost associated with handling and processing paper documents.
• Accuracy: ERAs can be automatically posted to a provider's billing system, reducing the risk of data entry errors.
• Transparency: ERAs provide detailed information about payments, adjustments, and denials, making it easier for providers to understand and manage their revenue cycle.

Standards

The ERA is governed by the Health Insurance Portability and Accountability Act (HIPAA) and must adhere to the standards set by the American National Standards Institute (ANSI). The standard format for ERAs is the ANSI 835 transaction set.

See Also

• Health Insurance
• Healthcare Revenue Cycle Management
• Remittance Advice
• Health Insurance Portability and Accountability Act
• American National Standards Institute