Electronic remittance advice -- what you need to know
Background
What is Electronic Remittance Advice (ERA)?
ERA is the electronic version of the standard paper remittances (SPR) that notify providers, billers, and suppliers of their claim payments and adjustments. These electronic notifications provide the same information that is found on the SPR, as well as additional information, including additional data and administrative efficiencies, not available in an SPR.
How is ERA generated, and how can the information be viewed?
The ERA is produced in the Health Insurance Portability and Accountability Act of 1996 - Compliant Accredited Standards Committee (ASC) X12N 835 format, often referred to as Transaction 835. This file is not easily readable and must be converted to a readable format. CMS provides free software for you so that you can download, view, and print duplicate copies of Part A or B electronic remittances whenever you wish. If you currently submit your claims electronically and are not set up for electronic remittance, please complete the Electronic Data Interchange (EDI) Enrollment form prior to downloading the free software.
- For Part A: PC-Print
- For Part B: Medicare Remit Easy Print (MREP)
Benefits of ERA
What are the benefits of ERA?
Using the ERA saves time and increases productivity by providing electronic payment adjustment information that is portable, reusable, retrievable, and storable. The ERA can be exchanged between partners with much greater ease than a paper remittance.
Here are a few benefits and advantages to receiving ERA:
- Faster account reconciliation through electronic posting;
- Reduce costs associated with:
- Storage and maintenance of SPRs
- Staff time to review and file SPRs
- Lower operating costs;
- More detailed information; and
- Free software.
Contact the EDI department at First Coast Service Options Inc. (First Coast) for further information on your situation and the availability of ERA for your office.
To assist in the transition from SPR to ERA, First Coast will allow you to receive both (SPR and ERA) for a period of time. This will ensure there are no interruptions in posting of payments for processed claims during the transition period.
Resources
- Health Care Payment and Remittance Advice: Provides information on ERA and companion documents for assistance with receiving the Transaction 835.
- Medicare Claims Processing Manual, chapter 22, section 40: Provides detailed information on the background and process of generating the Transaction 835.
- PC-Print: Free software provided by CMS for Part A providers
- MREP: Free software provided by CMS for Part B providers
- Electronic Data Interchange (EDI) Enrollment form: This is the form for Medicare providers who want to apply for or revise existing information pertaining to ERA.