Electronic Remittance Advice (ERA)
What is an Electronic Remittance Advice (ERA)?
An Electronic Remittance Advice explains benefit payment for Blue Cross and Blue Shield. An ERA shows which claims are paid and processed. This data in the HIPAA compliant format can then be posted to your accounts electronically. ERA eliminates the need for manual posting. The advantage is that the payment information is received in your office the day after the claims have been finalized.
Do I need specific software to receive an ERA?
The ERA is based on a provider's payment cycle and then delivered to an electronic mailbox. To access the mailbox, a single analog telephone line, asynchronous modem and communications software is needed. FTP Internet is also available. If you currently have a Submitter ID for Electronic Media Claims, (EMC), you may utilize the same Submitter ID to retrieve the ERA. Providers whose software is ERA capable can transfer an ERA to their computer. Some software offers a print option to allow you to print the Remittance Advice for review. You or your billing service will need translation programming to read the ERA. It is generated in the ANSI X12 835 format. Contact your software vendor for the availability of automatic posting software or programs.
What is an Electronic Payment Summary (EPS)?
The EPS is an electronic print image of the Provider Claim Summary (PCS). The EPS provides the same payment information you currently receive on your paper PCS. The advantage is that the payment information is received in your office the same day your ERA is delivered, the day after the claims have been finalized. The EPS can be used as a tool to assist you in the test process for your ERA automatic posting program.
What type of software do I need to receive the EPS?
The EPS is available the same way as the ERA is available. If your billing agent cannot accept the EPS, you can opt to have the EPS delivered to your own provider mailbox.
No special programming is required to receive the EPS. The EPS is only available in conjunction with the ERA.
How do I get started with ERA and EPS?
It is very easy... just access the Electronic Remittance Advice Form. Complete two forms if the EPS is requested to be delivered differently than the ERA.
If you have additional questions, please call the Electronic Commerce (E-Commerce) Center at (800) 746-4614.
|
BlueService is the difference that makes the difference.