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Balance an ERA (Procentive)

Gary M.
  • Updated

Overview

An ERA might have remaining credits (or takeback credits) which could be the result of transactions that were improperly allocated. This article will explain some of the possible causes for this and how to check for errors.
 

Possible Causes

Payment Amount Was Entered Incorrectly

Payment for a Claim Was Allocated Incorrectly

A Different Transaction Was Allocated Incorrectly

 

Payment Amount Was Entered Incorrectly

To review the payment amount:

  1. Open the ERA.
  2. Click Payment Entry Mode.

    ERA_Payment_Entry_Mode_Edit_Link1.png


     
  3. Click the Edit link at the top.
    • The New Payment window will appear.

      check_amount_in_payment_window_12-6-17.png

       
  4. Verify that Amount Received in the New Payment window matches the Amount at the top of Payment Entry Mode.
    • Payment Entry Mode reflects the payers report as the amount the payer paid.
    • If the amounts are different, correct the Amount Received in the New Payment window.
    • Note: These amounts should only be different if an ERA contains payments or takebacks for claims that were not billed out of Procentive.

      ERA_Amounts_Match1.png

 

Payment for a Claim Was Allocated Incorrectly

To review payments allocated for this ERA:

  1. Open the ERA.
  2. In Payment Entry Mode, click on a Claim number listed on the left.
    • The payment information will appear to the right.

      Review_Claim.png

       
  3. Verify the following:
    • The Paid and Amount Used Below match; the Amount Used Below should be green.
      • Note: The Amount Used Below will appear red if Takeback Credits are applied. In this situation, it's okay that the amounts do not match as long as the Takeback Credits match the amount paid for this claim.

        Paid_amount_Match.png

    • The Payment Reference listed on the claim (below) matches this ERA's Payment Reference (above).
      • This means the payment posted was from this ERA.

        Payment_Reference_Match.png

    • Click through each of the claim numbers on this ERA, to verify each for accuracy.

NOTE: If a correction is needed, the change will need to be done manually in the Payments Module. Click on the payments link to be taken to the Payments module for this client and Date of Service (DOS).

 

A Different Transaction Was Allocated Incorrectly

To verify the allocations applied on this ERA, compare the Allocation Report with Report Mode.

 

Allocation Report

While in Payment Entry Mode, click the Payment Reference link at the top.

Payment_Reference_Link.png

  • The Allocation Report (shown below) will open; it lists all allocations from this payment.

    Allocation_Report__1_.png

Report Mode

In the ERA, click Report Mode.

Report_Mode_Button.png

  • The Report Mode (shown below) is the payer's report; it details how the payer allocated the payment.
    • This is the equivalent to a paper EOB.

      Report_Mode_Sample.png

       

Compare the Allocation Report to Report Mode

If a discrepancy is found, the change will need to be done manually in the Payments Module. Click the pmt link in Report Mode to be taken to the Payments module for this client and DOS.


Helpful Hint: Print out the Allocation Report and Report mode to cross reference and mark off which claims are correct or which claims need to be resolved.

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