Work On ERA Responses That Can’t Be Autoposted

Process ERAs

Open the Electronic Remittance Advice tool and process ERAs.

To learn more, read Post Insurance Payments. Exceptions are added to the Posting Exceptions worklist whenever you process an ERA that contains something that could not be autoposted.

Review Unposted ERA Responses

Click on the “Posting Exceptions” tab to review claim 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, the exception reason, and the user who processed the ERA.

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

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

Work On a Posting Exception

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

The Posting Exceptions – View Details screen includes the full ERA section that couldn’t be autoposted, encounter details, and billing tools.

Understand What Happened With an Encounter

To understand the full story of what’s happened with an encounter, you can review the section of the ERA that pertains to the encounter.

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.

If PCC EHR Can't Find the Encounter: If a payor sent you an ERA response that doesn’t match an encounter that your practice 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.

For more information about using Edit Charges, read Edit Encounter Charges and Other Claim Information and Resubmit a 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 History tab.

For more information about manually posting insurance payments, read Post Insurance Payments and Adjustments.

Add a Note About the Exception’s Resolution

After you’ve taken action to address a posting exception, you can optionally add a new encounter billing note.

By adding a note, you’ll have a record of what happened if there are more issues with the encounter later.

Update the Exceptions Status

After you’ve taken action to address an exception or have discovered it is invalid and safe to ignore, update the exception’s status.

By updating the status, you mark the posting exception to indicate it cannot be posted, is a duplicate, is invalid, or has now been addressed manually. This will remove it from the default Posting Exceptions worklist. Later, you can revisit resolved exceptions using the Status filter.