Introduction to EDI Reports

Your office receives many different electronic reports related to claims or other electronic submissions. These include:

  • Electronic Claims Reports: After you submit claims using the preptags and ECS programs, you receive a series of claim status reports and summaries.

  • E-Bills Reports: When you send out electronic personal bills, you receive reports about which bills were sent successfully.

  • ERAs: Some insurance carriers send an Electronic Remittance Advice (ERA), which contains an explanation of benefits that may replace the traditional paper EOB. You can read the original ERA files in the ecsreports program. If you use autoposting, you can review processed, ERA check files in erareports.

  • Eligibility: Finally, PCC creates a daily Eligibility Report for scheduled patients with participating carriers and sends it to your practice.

The help articles in this section will teach you how to read and use the information in these reports.

What is "EDI"?: EDI stands for “Electronic Data Interchange.” When you submit electronic claims or receive electronic reports, you are using EDI. PCC has a dedicated support team for EDI issues, available at 1-800-722-1082, option 3.

Do Not Ignore Your Reports!: Reading your electronic reports is a vital part of the billing process. If claims with errors or rejections are not corrected and resubmitted, you may never receive reimbursement for the work your practice performs. The sections below will teach you all you need to know to manage this task.

Where Do I Read EDI Information?

You can review and work with EDI information in many different ways:

  • Post ERAs in the Post Insurance Payments (autopip) Program: Electronic Remittance Advice will appear in the autopip program. When you are ready to post payments and adjustments, run autopip and select the ERAs.

  • ’EDI: ecsreports[/prog])’]All EDI reports are stored in the ecsreports program. Read below for a complete guide to using ecsreports to manage your EDI data.

  • E-mail: Partner can e-mail your EDI reports directly to a user or users at your practice. E-mails are not as organized or powerful as using the ecsreports program, but small offices may prefer this method. If you need to change which member of your staff receives EDI reports, contact PCC Support.

  • Correct Mistakes (oops): Claim EDI information for some carriers is available in the oops program. While viewing a charge in oops, you can press F4Insurance Status and select responses for claims handled by the Emdeon or Copario clearinghouses. The relevant section of the original EDI report will appear on the screen. Read the Correct Mistakes manual for more information.

  • Patient Check-In (checkin): Eligibility information from participating payors is sent to your office daily. Partner pulls the most recent eligibility information for scheduled patients and displays it on the second step of the checkin program.

  • Last modified: March 8, 2015