Work On ERA Responses That Can’t Be Autoposted

Open the Posting Exceptions Worklist

Click on the “Posting Exceptions” tab in the Electronic Remittance Advice tool.

Review the List of Unposted ERA Responses

On the Posting Exceptions tab, you can review a list of payor responses that could not be autoposted.

For each encounter, you can see the status, the date the ERA was processed, the check number, the remittance date from the ERA, the payor, the patient, the date of service, and the exception reason description.

You can click on columns, search the list, or use filters at the bottom to find specific encounters you wish to work on.

Status: By default, each ERA response that cannot be autoposted is assigned a status of “Needs Attention”. By filtering by this status, you can isolate the encounter responses that still need to be addressed.

View More Details of a Posting Exception

Double-click on a posting exception to review more details and address it.

Review ERA and Full Encounter Billing Details

On the Posting Exceptions – View Details screen, you can review encounter details and the encounter’s section of the ERA that could not be autoposted.

You can scroll down to review Encounter Billing Notes, Account History, and Claim History to understand the full story of what’s happened with the encounter so far.

Encounter Based: PCC EHR can only display the billing notes, history, and other details if it can identify the encounter on your system. If a payor sent you an ERA that doesn’t seem to match an encounter that you billed, some of these billing-related components will not appear.

Edit Charges and Other Encounter Details

If you need to edit something about the encounter in order to post the payor’s response, click “Edit Charges”.

From the Edit Charges screen, you can edit diagnosis and charge information, the responsible party for charges, and other details about the encounter. You can optionally jump to Patient Demographics in order to adjust the patient’s policies. When you are finished making changes, you can optionally queue up a new claim.

Manually Post the ERA or Edit Insurance Payments

When you are ready to post the ERA manually, or if you need to make changes to other payments on the account and then post, click “Insurance Payments”.

If the encounter can be identified, the Insurance Payments tool will open to the payment screen and you can manually post details from the ERA. The relevant section of the ERA will appear below the payment and adjustment section for your review. If the information on the ERA is not detailed enough for PCC to identify the account or the encounter, you will see the Insurance Payment search or selection screens instead.

If you need to make changes to other payments and adjustments before you can post the ERA response, use the Payment History tab.

Add a Note and Update the Status

After you’ve taken action to address a Posting Exception, you can add a new encounter billing note and then update the exception’s status.

By adding a note, you’ll have a record of what happened if there are more issues with the encounter later. By updating the status, you can mark the posting exception to indicate it was posted manually, a duplicate, invalid, or cannot be posted and remove it from your worklist.