Electronic Remittance Posting, v. 3.19 and Later

Each carrier that requires a unique posting configuration of the 835 ERA should be set up in the Electronic Remittance Dictionary. You do not need to set up a posting configuration per carrier, you only need to create multiple configurations if you want different rules to be applied to different payors. (Example: if you want to post write-offs for payments received from Medicare but do not post write-offs if the payment is from Blue Cross, you would create two posting configuration set ups to accommodate the different rules.)

To add a posting configuration for a carrier

The following steps outline how to create a new item. Unless otherwise indicated, all fields are mandatory and must be complete in order to save the posting configuration in the dictionary. This dictionary is Business Entity specific and is not shared.

Click New Item from the Actions sectionActions section in the upper right of the dictionary. The Edit new Electronic Remittance Posting item dialog appearsEdit new Electronic Remittance Posting item dialog appears. Complete the following fields.
Complete the following fields, using the ERA item for Medicare as an example.
Name: Enter a description for the entry. The entry must be unique to all other items in the dictionary. (Example: ERP Medicare) This name will be seen on other screens where the item is to be selected and used.
Quick Code: Enter a short name for the item. This name may be used when displaying information about the item in a table format.
File Format: The system will default to 835 General Format.
EOB Format: Select the applicable format from the drop down list. Options are Medicare, Blue Cross or Commercial. Use Commercial for any carrier that is not Medicare or Blue Cross.
Complete the following fields:

Payment Code: Select or create a Payment journal code for use when posting payments for this ERA Carrier. Use the Alt + E key to jump to the Journal Code Dictionary if you need to add a new code. (example: ERP BC Payment)
Payment Type: Select from the drop down the form of payment that will generally be received, Card, Cash, Check or EFT.
Zero Payment Handling: If a transaction on the ERP has a zero payment, the optionoption you check here will determine what the system will do with the transaction.

Note: The system will default to reject all write-offs associated to a zero payment, regardless of the payment posting option selected.

Transfer to Next Role: If you would like the system to automatically transfer any balance due to the next responsible party in the Billing Group when payments are posted, select Yes (default). If you do not wish to auto transfer select No. If you select No, users will be required to review all transactions and manually transfer the balance to the next responsible party if needed.

Note: The Transfer to Next Role setting does not apply to the Zero Payment transactions. The setting to transfer charges with zero payment is handled by the designated drop-down option, "Zero Payment Handling."

Transfer Code to SI: Select or create a Transfer Code for use when a balance due is transferred to the Secondary Insurance. (example: ERP Transfer to SI)
Transfer Code to TI: Select or create a Transfer Code for use when a balance due it transferred to the Tertiary Insurance. (example: ERP Transfer to TI)
Transfer Code to PG: Select or create a Transfer Code for use when a balance due it transferred to the Primary Guarantor. (example: ERP Transfer to PG)
Lump Write-off: This setting combines adjustments with the same group/reason code into one line item on the patient ledger.
Post Write-offs for Adjustments: Check off the box(s) if you would like the system to post adjustments to any of the group codes group codes displayed.
1. - Contractual Obligation (CO)
  - Corrections and Reversals (CR)
  - Other Adjustments (OA)
  - Payor Initiated Reduction (PI)
Post Adjustments: Check off the appropriate box(s) if you would like the system to post the following to Charge Details:

Patient Responsibility (PR)

Deductible (PR1)
Coinsurance (PR2)
Copayment (PR3)

These transactions will be pulled into the charge detail page and are used to balance the due amount when processing secondary or tertiary claims.
The amount listed in the PR field will be updated based on the information provided by the last payor. (Example: PR1 is reported as 500.00 from the Primary. This amount will be posted to the deductible field when the ERA is processed from the primary insurance. If an ERA file is then later processed from the secondary insurance and the PR1 is reported at 250.00 in the ERA file from the secondary, the Deductible field in the charge detail page will be updated to 250.00.)

Note: Patient Responsibility transactions are posted as information only to the fields on the Charge Detail screen.

Post Surcharge

CO-137
PR-137

Note: Specific rules have been put in place for the posting of these items identified as Surcharges. Click here for details on these transactions (v. 3.19). If you are on AmkaiOffice v. 3.19.1 or later, click here.

Write-off Journal Code: (optional) Select or create a Write-off Code that can be used by the system to apply a write off against the charge. (example: ERP Contractual W/O)
Write-off Max Amount: (optional) Enter an amount to indicate the maximum amount you would like the system to write off as an adjustment when posting ERPs for this carrier. Enter positive values only. (example: 99.99) If the field is left as the defaulted 0.00, the system will assume no max amount.
Write-off Correction Code: (optional) Select or create a write off correction code that can be used to reverse a previously posted write off. This option is useful if you have taken the contractual adjustment at the time of posting your charge and the write off may have been slightly overstated. Allowing the system to automatically reverse all or part of the write off could avoid a negative balance on charges or prevent the system from posting no payment at all if the balance due exceeds 0.00 when the payment is posted. (example: ERP Correction W/O)
Write-off Correction Max Amount: (optional) Enter a positive dollar value that you would like to allow the system to do the write off correction for. (example: 0.01) If the field is left as the defaulted 0.00, the system will assume no max amount.
Write-off Code for Small Balance: (optional) Select or create a Write-off Code that can be used by the system to remove a small balance that may remain on a charge after the payment has been posted. (example: ERP Small Balance W/O)
Small Balance up to: (optional) Enter an amount to indicate the maximum amount you would like the system to automatically write off as small balance when posting ERPs for this carrier. Enter positive values only. (example: 4.99)
Interest Payment Code: (optional) Select or create a Payment Journal Code that can be used by the system to post a payment received in the ERA file for interest from the payor. (Example: ERP Interest Payment )

Note: The system will post a payment and debit for interest against the first charge associated to the transaction in the ERA file for the patient. Interest is identified in the ERA file when AMT|01 is included. AMT 02 segment is used to determine the amount of the interest payment.

Allow Negative Due: Select Yes (default) if you would like to allow the system to post payments that exceed the due amount on the charge. Select No if you do not wish to allow negative due on charges. If you select No, the system will not post any payments to the charge if the resulting balance will exceed 0.00 due.

Note: If there are write offs associated to the payment the system may post the payment but reject the write off if by posting the write off a negative balance would result.

Surcharge Debit Journal Code: (optional) Select or create a Debit Journal Code that can be used by the system to post a surcharge received in the ERA file. (Example: ERP Surcharge Debit)
Surcharge Debit Correction Journal Code: (optional) Select or create a Debit Correction Journal Code that can be used by the system to post a debit correction against the debit surcharge when included in the ERA file. (Example: ERP Surcharge Debit Correction)

ERP Folder Path: Use the check mark to browse to the location you will store the 835 Remittances Advice as they are downloaded from your clearing house or other source. If you are working in an Enterprise database you should set up a unique folder for each Business Entity. Your organization may set up as a unique folder for each type or carrier that will be posted using the ERA option. (example: C:\ERP_ASC). Click herehere for more information.

A folder must be created (preferably on a network drive for access by multiple users) and used for housing all of the electronic remittance posting files. These files should be received by the center through their regular channels and then moved to the folder created for the sole use of AmkaiOffice ERA Posting. The assistance of IT staff may be required to set up the new folder on your network
Insurance Carrier: Select the carrier from the drop down menu that will be associated to ERAs posted using this entry. (example: Blue Cross/Blue Shield). If the configuration is specific to an individual payor select that payor here. If the set-up is to be used for all payors you do not need to make any selection. The parameters will be applied to all payors.
Click one of the following buttons:

- Save and DoneSave and Done
  
  Click to save your changes and return to the Items screen.
- Save and NewSave and New
  
  Click to save your changes and clear the fields on the dialog, so you can add another new Item to the dictionary.
- CancelCancel
  
  Click to discard your changes and return to the Items screen.

To learn how to search, edit and activate/deactivate dictionary entries and print a dictionary report, see Editing Dictionaries.