This article provides step-by-step instructions on how to view ERAs and use the auto-posting feature in Elation Billing.Documentation Index
Fetch the complete documentation index at: https://help.elationhealth.com/llms.txt
Use this file to discover all available pages before exploring further.
ERA and auto-posting basics
What is an ERA?
An Electronic Remittance Advice (ERA) is an electronic version of an Explanation of Benefits (EOB) sent by insurance payers. It contains detailed payment information including allowed amounts, adjustments, and patient responsibility.Why is viewing ERAs important?
ERAs enable efficient payment posting by providing structured payment data that can be auto-posted to claims. This reduces manual data entry, speeds up payment processing, and minimizes errors.Prerequisites
Before you can view and auto-post ERAs, confirm the following:- User role: You need one of the following roles to view and auto-post ERAs:
- Admin
- Manager
- Biller
- BillCo Admins
- BillCo Staff
- Data Entry
- ERA enrollment: The payer must be enrolled for ERAs through ClaimMD. See Enrolling for Claims Submission, ERA, and Real-Time Eligibility (EDI).
- Timing: After enrollment is approved, ERAs typically begin arriving within 1–2 payer payment cycles, often 2–4 weeks. In the meantime you should still be receiving remittances in the mail or you can view your remittances via an external payer portal.
- If no ERAs appear after this window, see Troubleshooting.
Workflow Instructions
Viewing the ERA list
The ERA list defaults to all ERAs that have not been reviewed. Use the filters and search box to narrow results. Available filters include:
- Reviewed Status - All, Reviewed, Not Reviewed
- Posted Status - All, Posted, Needs Review, Not Yet Posted
ERA list columns
The ERA list displays the following columns:| Column | Description |
|---|---|
| Payer | Insurance payer that sent the ERA |
| Paid Date | Date the payer issued payment |
| Paid Amt (Amount) | Total payment amount on the ERA |
| Reviewed (status) | Current ERA status (see below) |
| Posted (status) | Current posting status (see below) |
| Check/EFT # | Check or EFT reference number |
| (# of )Paid Claims | Number of paid claims included on the ERA |
| (# of )Zero Pay Claims | Number of claims with $0 payments included on the ERA |
Reviewed (status) labels
- Mark Reviewed - Click to manually mark the ERA as reviewed.
- Reviewed - Someone in the practice has reviewed the ERA, confirmed the posting and marked the ERA as reviewed.
- Unreviewed - New ERA, not yet posted or reviewed
Posted (status) labels
- Auto Post Now - Click to auto-post payments in the ERA to claims.
- Auto Posted - All the payments in the ERA were successfully auto-posted to claims.
- Needs Review - Certain payments in the the ERA could not be posted during when auto-post was triggered. Someone needs to review the unposted payments.
Viewing a specific ERA
To view a specific ERAAuto-Posting ERAs
To auto-post an ERA:What the auto-post scan checks
The scan verifies that each claim on the ERA can be matched and posted without ambiguity. Common blocking issues include:- Missing or mismatched Superbill ID
- Claim not found in Elation Billing (e.g., claim was deleted or sent from a different system)
- Duplicate claim matches
- Missing metadata such as service line detail, CPT codes, or adjustment codes
How auto-post handles payment details
When auto-posting succeeds, the system applies the following automatically:- Allowed amounts are recorded per service line
- Contractual adjustments (CARC codes like CO-45) are written off to the appropriate adjustment category
- Patient responsibility (copay, coinsurance, deductible — PR codes) is transferred to patient balance
- Secondary/tertiary balances are queued for crossover or secondary submission if a secondary payer is on file
- Denials (CO, OA, PI codes without payment) are flagged but not automatically worked — you must review these manually
We do not advise auto-posting ERAs with Denials, to avoid the creation of clerical errors. Review denied claims individually and work them through the claims workflow.
Partial auto-posting
Elation auto-posts the entire ERA as a single action — partial posting of individual claims from one ERA is not supported. If any claim fails, the full ERA is marked Cannot Auto Post.
Reviewing auto-posted ERAs
An ERA that was successfully auto-posted, will say Auto Posted in the Posted column. Click the Auto Posted button to go straight to the payment details.- Review the payment(s) for accuracy. Look for things like negative balances or zero payments.
Marking ERAs as reviewed
After you’ve reviewed auto-posted or manually posted ERAs and are satisfied with the results, click Mark Reviewed in the Reviewed column. Marking an ERA as reviewed:- Removes it from the default (unreviewed) ERA queue.
- Records a timestamp and the reviewing user for audit purposes.
- Does not change the posted payment — only the reviewed status.
Troubleshooting
ERA cannot autopost
Occasionally, an ERA will be unable to autopost. This is most often due to:- Missing/Mismatched Claim Info - If the ERA is missing claim info (e.g., Superbill ID), the ERA will be unable to autopost.
- Missing Metadata - Occasionally the payer will fail to include pertinent metadata attached to the claim data (e.g. service line breakdowns or adjustment reason codes).
- Reversals, takebacks, or recoupments - ERAs that reverse prior payments require manual review and cannot auto-post.
Missing ERAs
If you were receiving ERAs for a payer and they have stopped arriving, or you expected ERAs after enrollment and none appear:Verify the payer issued payment — log into the payer portal or call the payer to confirm a check or EFT was sent.
Duplicate ERAs
If the same ERA appears twice, do not auto-post both. Review the check/EFT numbers and- if they match, post one and mark the duplicate as reviewed without posting.
- if the amounts differ, the payer may have issued a corrected ERA. Post the corrected ERA and mark the duplicate ERA as reviewed without posting.
Reversals, takebacks, and recoupments
Payers sometimes reverse a prior payment or recoup funds on a subsequent ERA. These cannot be auto-posted and must be manually posted against the original claim.ERA vs EOB mismatches
If the ERA total does not match the paper EOB or bank deposit:CARC and RARC codes
ERAs use standardized codes to explain adjustments:- Claim Adjustment Reason Codes (CARC)- Explain why an adjustment was made (e.g.,
CO-45= charge exceeds fee schedule) - Remittance Advice Remark Codes (RARC) - Provide additional context for adjustments
Reporting
ERA data will appear in the following reports:- Lightning Insights
- Lightning Reports
- Charges and Financial Transactions Report
- Deposit Report
- Denials Report
- Provider Payment Report