Read ERAs

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Open the Electronic Remittance Advice tool to review payments and adjustments sent to your practice electronically.


Payers send adjudication to your PCC system as ERAs, also known as 835 files. For each ERA, you can see the Remittance date, when the ERA was processed, the payor, the complete check number, and the total amount of the check associated with the ERA.

You can filter the list of ERAs by whether they are Processed, Unprocessed, or Deleted.

You can also search your practice’s ERAs. For example, you could look for the ERA pertaining to a specific check number or review all ERAs from a specific payor.

Review ERA Details and Processing Summary

Double-click on an ERA to review its contents.


At the top, PCC indicates whether the ERA has been processed and by whom.

Next, summary information about the ERA appears in three or four sections.

  • ERA: The ERA section at the top describes the basic information about the ERA, including the remittance date, payor, complete check number, and amount.

  • Processing Summary: If your practice has processed the ERA, the next section describes the results, including total amounts and number of claims for payments, adjustments, and exceptions. You can also see how many claims on the ERA were adjudicated as being the primary, secondary, etc. policy for the patient.

  • Payor: The Payor section includes details about the payor as found in the ERA 835 file, including their provided adjudication and remittance dates, the complete check number, amount, and electronic banking information. The payor may include various types of contact information on an ERA. For example, they may include optional additional contact details which will appear as “Tech Email” and “Tech Phone”.

  • Payee: The Payee section includes information about the entity receiving the ERA and the payment. Typically, this is your practice. This section will display the practice name, address, and banking information as reported by the payor.

Review Specific Claim Responses and Payment Processing Results

Below the summary sections, PCC displays detailed payment and adjustment information for each claim referenced on the ERA.

Claim Identifiers

For each claim on the ERA, you can see the patient’s name, PCC ID, Payor Claim Control Number, patient’s insurance ID, and (if the ERA has been processed) whether it was processed as being the patient’s primary, secondary, etc. policy.

  • PCC ID: The PCC ID is a combination of the patient PCC number, a space, and the claim ID number generated on your system when you processed claims.

  • Payor Claim Control Number: The Payor Claim Control Number, sometimes called the Internal Control Number (ICN), is issued by the payor to identify the claim. It’s common for payors to require the Payor Claim Control Number when you submit a corrected claim.

  • Insurance ID: The Insurance ID is the patient policy insurance number, found on the patient’s insurance card and stored with the policy on the patient’s record.

    • Payments and Adjustments

    Underneath the claim identifiers, a table displays detailed information about each charge on the claim.

    The table and the details beneath explain the payer’s adjudication.

    • Charges and Payment and Adjustment Amounts: For each charge, you can see columns for the date of service and procedure code followed by columns for the amounts of the charge, deductible, copay, personal responsibility, total personal due, contractual adjustment, other adjustment, and payment as reported by the payor on the ERA.

    • Downcoding: If the payor changed a procedure code for a charge, a special “Submitted if Different” column will appear so you can compare the code you submitted on the claim to the code being reported by the payor.

    • CARC, Group, and RARC: When a payer includes CARC, Group, and RARC information for a charge, you can see it inline in the table. For definitions, you can expand the Key below each claim.


    • CORE Business Scenarios: When PCC identifies that a payor’s response matches a CORE business scenario, you can see a description underneath the table. These scenarios can help you understand the payor’s response more quickly. For more information, you can read about the CORE Code Combinations as explained in the CAQH operating rules.

    • Exception Reasons: When the ERA has been processed, and the payor’s response to the claim could not be automatically posted, PCC displays the Exception Reason, which defines why the response requires your manual attention.

    Work on Claims that Could Not Be Posted Automatically

    When your PCC system could not post payments and adjustments automatically, a “Payment Exception” reason appears below the adjudication table. You can use the details on an ERA, along with the Exception Reason, to understand what action to take next.

    You can filter the ERA to display only claims with payment exceptions and optionally print the result.


    For each claim with a payment exception, you might decide to contact the payor, post the payments manually, or change the responsible party for charges and generate a new claim. You can learn more and review a list of all payment exception reasons in the Post Insurance Payments article.

    When you post the response manually, you can bring up the encounter charges automatically by entering the Claim ID, which is the second part of the PCC ID on the ERA.



    The Manual Report?: Prior to PCC 9.9, your billers may have automatically posted payments and worked on posting exceptions (the “Manual Report”) on the screen in Practice Management. In PCC 9.9, they can use the Electronic Remittance Advice tool and filter for Posting Exceptions as shown above to review the same details with greater clarity and ease-of-use.

Less-Common Payments

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Open the Holding Account

Open your practice’s holding patient account named for the type of payment you need to post.


Your practice can set up holding accounts named for different kinds of payments and optionally include the name of a specific insurance group.

Navigate to the Billing History

Click on the History chart navigation button and then click Billing History.

Click Create Encounter


You can use the “Create Encounter” feature to record many different types of financial transactions, such as any fee not associated with an encounter or the less-common types of income described above.

Select a Provider and Optionally Update the Place of Service or Date

Select a provider for the administrative encounter. According to your practice’s accounting practices, you may also need to adjust the place of service or date of service.

Select the Appropriate Adjustment Procedure and Enter an Amount

What is the payment for? In the Procedures section, find the adjustment procedure (such as “Insurance Interest”) that will offset the payment you received. Enter the amount of the payment as the “Price” of this adjustment.


Self Pay: Whenever you enter an adjustment procedure to offset these types of payments on a holding account, you post the procedure as “Self Pay”. Self Pay will be selected by default.

Enter Payment Details

In the Payments section, select the Payment Type (such as “Insurance Interest”), and enter the amount and check number. The full amount of the payment should be applied to “today’s visit”.

Click Save + Post

Click “Save + Post” to record the adjustment procedure and payment on the holding account.



You can review what was posted on the Billing History and use the Billing History Index to review all payments posted to the account.

Outlines: Accounting Challenges

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Outlines: Import, Work With, and Share Patient Documents and Forms

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Import, Work With, and Share Patient Documents and Forms

Learn how to get documents into PCC EHR, attach them to patient charts, and generate forms for patients and families.

Outlines: Communicate with Patients and Take Messages

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Communicate with Patients and Take Messages

Learn how to take notes during patient phone calls, send text messages to patients and families, and communicate with patients and families through the patient portal.

Work with Phone Notes

Send Text Messages to Patients and Families

Communicate with Patients and Families through the Patient Portal

Outlines: Update Demographics and Insurance Policy Information

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Update Demographics and Insurance Policy Information

Work with patient and family account records and update a patient’s insurance policies.

Outlines: Get Started

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Get Started

Learn how to log in, navigate in PCC EHR, and use chat.

Log In to PCC EHR

Navigate PCC EHR

Chat with Colleagues

Not Legal Advice

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Consult Your Practice's Legal Counsel: PCC shares what we learn about pediatric industry issues and best practices, but we do not provide legal advice. For questions, consult your practice’s legal counsel.

CPT Disclaimer

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Procedure Code Guidance: The procedure code recommendations in this article are intended only as examples. You should consult the AMA’s CPT Coding Guide and work with your insurance payers to verify what codes you should use on claims. Your practice updates and maintains your procedure list, codes, and prices in the Procedures table in the Table Editor on your PCC system.

Category: Office Workflows

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PCC maintains a collection of workflows you can follow to make best use of PCC EHR. If you want help exploring these workflows, reach out to PCC.

Work Unpaid Claims Snippet

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After your practice submits claims, you must address claims that could not be submitted, post incoming adjudication that appears on ERAs and EOBs, and followup on unpaid claims. While many of these functions are performed in PCC EHR, a few of these tools still utilize the previous Practice Management interface.

Documents Section Snippet

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How do you import a lab result, attachment, or other document into a patient’s chart? First, you can scan, fax, or print the file into PCC EHR, and then you import the document to a patient’s chart. Along the way you can link the document to a particular visit or order, and you can specify whether or not the family can see the document in the patient portal. Read the articles below to learn more.

Update Patient and Family Information

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When you work with patients and families, you need to update their demographics, adjust their billing account, flag accounts for various needs, and more. How do you set a patient’s confidential communication preference? How do you handle a family with two households?

PCC EHR’s demographics components appear in the Demographics section of the patient chart, and they can also appear during Patient Check-In, on the chart note, or anywhere your practice needs them. By mastering these components, you’ll be able to help your families quickly and easily.

Read and watch the topics below to learn how to update patient and family records.

Sam vs Appointment Book

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SAM or the Appointment Book?: PCC offers two different sets of scheduling tools. This article refers to scheduling functionality found in the Practice Management system, where you schedule with SAM. For help with PCC’s Appointment Book, the visual scheduler found in PCC EHR, visit Schedule a Patient.

eRxMorganCategory

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PCC’s eRx Expert, Morgan Ellixson-Boyea, CPhT, provides online Web labs, local seminars, and publishes articles to help your practice make the most of your PCC EHR ePrescribing solution.

Check out the videos and articles below to learn prescribing best practices and tips from Morgan!

eRx Playlist

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Topic Video Article
Prescribe Medications Watch
(7 min)		 Read
In about 7 minutes, learn how to prescribe medications in the new PCC eRx.
Rx Queue – Alternative Prescribing Workflows Watch
(6 min)		 Read
Learn about the Rx Queue, renewal requests, and how provider agents prescribe.
Weight-Based Dosing and Other Prescribing Tools Watch
(8 min)		 Read
Learn more about how to use the dose, frequency, days supply and other features when you prescribe.
Medication History Watch
(9 min)		 Read
Quickly review and update a patient’s medications, review pharmacy history, and renew medications.
Allergies Watch
(5 min)		 Read
Learn how to record and review patient allergies and handle drug allergies as you prescribe.
Set Up PCC eRx Users Watch
(7 min)		 Read
Learn how to set up staff and clinicians in your office to use the e-prescribing features in PCC EHR.
EPCS: How to Enroll Prescribers and Prescribe Watch
(10 min)		 Read
Enroll in EPCS, perform identity proofing, and prescribe a controlled substance electronically.
PCC eRx 2017 Migration Considerations Read
Your practice’s eRx champion or PCC expert can read about all the different issues related to the eRx transition.
PCC eRx Component Reference Read
Read special tips and tricks of each component on the PCC eRx ribbon.

Category: Patient Portal

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My Kid’s Chart is an online tool that patients and families can use to access medical records, review lab results, generate an immunization record, review their visit history, or send a message to their pediatrician’s office.

Get a Patient Portal Starter Kit For Your Practice: PCC provides an informational handout for patients and families, registration forms, and custom flyers for your practice. You can learn more, download the kit, and request a custom flyer on PCC’s Patient Portal Kit page.

Download a Manual: You can download and print a PDF manual for patients and families here: My Kid’s Chart User’s Guide.

Category: Interfaces

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PCC’s interoperability teams build connections with immunization registries, HIEs, hospitals, lab vendors, insurance payers (for eligibility and electronic claim submission), billing services, scheduling services, and more.

To learn more about PCC’s interfaces, or to request a new interface with a payer, vendor, or other service, visit PCC Interoperability on pcc.com.

You can check if PCC already has an existing interface with a hospital or other vendor, and find out how to order a new connection. As always, contact PCC Support (800-722-7708) with any questions.

Portal Messages vs Direct Secure Messaging

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Patient Portal Messages vs. Direct Secure Messaging: The patient portal and PCC EHR support two different messaging technologies. Portal messages are a secure, optional messaging tool built into the patient portal. Patient portal users can exchange messages with their pediatric practice, and the practice can receive and send portal messages with PCC EHR or pocketPCC. Direct Secure Messaging, on the other hand, is a specialized message technology used to share and send medical information. It requires registration with a third-party service and it allows for secure transmission of C-CDA transition of care documents or visit summaries. For more information, refer to Receive and Respond to Portal Messages or Direct Secure Messaging.

7.0.4 Search For ICD-10 Diagnosis Codes

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Search By ICD-10 Codes for Diagnosing and Problem Lists

You can now search by ICD-10 code or description when you add a diagnosis to a patient’s chart, either in the Diagnoses component or on the Problem List.

When you can’t find a SNOMED-CT diagnosis description, use your mouse to right-click on the field and select “Find Other Diagnosis…”.


In the Find Other Diagnosis window, enter a search string. You can search for diagnosis descriptions using SNOMED terminology, and in PCC 7.0.4, you can also search by ICD-10 codes.

If a clinician knows the billing code but does not know the chart diagnosis description, they can now enter the billing code to search for matching results. This matching is reliant on the National Library of Medicine’s assisted mapping between SNOMED-CT and ICD-10, or on your practice’s custom billing configuration.

2015-10 Immunization Forecasting Patch

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Immunization Forecasting Logic Update

PCC’s immunization logic partner, STC, is implementing several patches to the Immunization Forecasting features in PCC EHR. The new changes will bring Forecasting Results and Forecasting Warnings more in line with ACIP standards.

  • Age Restriction Adjustments: PCC’s configuration for age restrictions have been adjusted to the ACIP default. The previous configuration caused immunizations such as Hib and HPV to be ignored for patients within certain age ranges.

  • MSPV Forecasting: MSPV administered at 11 years of age will now result in an Immunization Forecasting Result for MCV at 16 yrs of age.

  • Hib Update: Dose 3 of Hib administered at 12 months of age or older, with less than an 8 week interval from previous dose, generated a Forecasting Warning, but was still shown as valid. Dose 3 Hib without the proper interval will now display as invalid as well as produce a warning.

  • 2015-16 Seasonal Influenza Recommendations: For 2015–16, ACIP recommends that children aged 6 months through 8 years who have previously received 2 or more total doses of trivalent or quadrivalent influenza vaccine before July 1, 2015, require only 1 dose for 2015–16. The two previous doses need not have been given during the same season or consecutive seasons. Children in this age group who have not previously received two or more doses of trivalent or quadrivalent influenza vaccine before July 1, 2015 require 2 doses for 2015–16. The interval between the 2 doses should be at least 4 weeks. Immunization Forecasting Results will make recommendations in accordance with these new guidelines. (Visit CDC.gov for more information)

  • PPSV Forecasting: Immunization Forecasting Results and Warnings in PCC EHR will now match ACIP interval recommendations for PPSV and PCV-13 for patients 65 years or older.

Certification Status

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PCC EHR is Prevalidated for PCMH: By using PCC EHR, your practice is pre-validated for automatic credits towards PCMH recognition. Many pediatric practices have used PCC to achieve PCMH recognition.

Category: Meaningful Use, CQMs, etc.

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Pediatric practices can apply for various Patient Centered Medical Home programs to receive payments while improving patient care.

PCC EHR is Prevalidated for PCMH: By using PCC EHR, your practice is pre-validated for automatic credits towards PCMH recognition. Many pediatric practices have used PCC to achieve PCMH recognition.

Where is the EHR Medicaid Incentive Program?: From 2011 to 2017, many practices used PCC EHR to participate in the EHR Medicaid Incentive Program, sometimes referred to as the “ARRA” or “Meaningful Use” program. PCC EHR still includes reporting tools for measures in those programs and for understanding your medicaid population. For more information, talk to PCC Support.

Category: Prescriptions Introduction

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PCC EHR has a complete suite of tools for managing medications and prescriptions.

As you create prescriptions in PCC eRx, you can review and update patient medications, track and use a family’s preferred pharmacies, review a patient’s drug benefit plan and pick medications accordingly, and review alerts related to a patient’s drug allergies, drug-to-drug interactions, and other circumstances. PCC eRx is endlessly customizable, and you can use powerful features like weight-based dosing and built-in dosing statements to improve your patient workflow, save time, and provide better care.

Watch and read the content below to learn more about PCC eRx and medications in PCC EHR.

Refund Intro

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Use the refund program to make personal account refunds. You can also use the refund program to post other types of accounting adjustments.

Follow Up On Unpaid Bills Introduction

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Unfortunately, not every family pays their bills on time. An address may be incorrect, a family may have questions about their balance, or they may be unable to pay. Following up on outstanding bills is a vital part of the billing process.

Chart Note Configuration Introduction

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You can use PCC EHR’s Protocol Configuration Tool to create and edit custom chart notes, phone notes, and order follow-up notes in PCC EHR.

  • First, you can design and edit components, or the “building blocks” for a chart note, in the Component Builder.
  • Next, you can use the Protocol Builder to assemble those components into protocols and configure their onscreen behavior.
  • Finally, the Protocol Map controls which protocols will be used to generate chart notes for provider visits.

Good custom protocols lead to faster and more efficient charting and result in more consistent care for patients. PCC Software Support can train you on the PCC EHR Protocol Configuration Tool and provide ongoing support as your providers adapt PCC EHR to their workflow.

Check Out Awesome Examples: PCC hosts a web site displaying protocols created by pediatric practices around the country. You can review these award-winning chart notes at protocols.pcc.com.

Pocket Partner

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Pocket Partner was a portable program for accessing your PCC schedule, reviewing patient information, and creating phone encounter notes. Pocket Partner ran on smartphone browsers.

PCC has replaced Pocket Partner with pocketPCC. For help making the transition to pocketPCC, contact your PCC account team.

Category Description: PCC EHR

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PCC EHR is a customizable, pediatric focused electronic charting system. It tracks and maintains medical records for patients and provides a workflow environment for clinicians to see patients, manage their schedule, and chart visit information.

pccehr265

Use the articles and videos below to learn how to chart a visit, create and complete visit orders, and perform other tasks.

Advanced Billing Functions and Configuration

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Before PCC EHR, PCC developed and maintained the Partner practice management suite of tools for pediatric scheduling, billing, and other functions.

PCC EHR has replaced Partner, except for some remaining advanced billing tasks and some under-the-hood configuration for your practice.

If you are a biller or your practice’s PCC “super user”, you can use the articles and videos in these sections to learn how to use the “Practice Management” windows in PCC EHR to meet these needs.

If you would like documentation for deprecated software, such as our previous scheduler (SAM) or the Family and Patient Editors (fame, notjane), it is available upon request.