Automatically Posted Payments (ERAs)

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This article describes how insurance payment information received through ERAs is automatically matched to claims in Avea, removing the need to manually post those payments. 

Automatic Payment Posting Process

Once your ERA enrollments are complete, the clearinghouse will automatically transmit all received ERAs directly into Avea. Avea will use ERA details to match the payment information received to the patient and claim. When the ERA is matched to a claim, the payment details are automatically posted to the claim and Avea will put that matched claim and payment into the Review Queue with a follow-up date for the next business day. 


What if there is an issue with the automated payment posting?

If there is an issue with the automatic payment posting process, the payment will end up in one of three buckets, each with an associated tile in the Organization Dashboard.

  1. Insurance Payments Requiring Review
  2. Insurance Payment Collections in Review
  3. Insurance Claims Out of Balance

Reviewing Automatically Posted Payments

Any time a payment is mapped to a claim, AveaOffice will automatically place that claim in the EOB Review Queue and set the follow-up date to the next business day.  This ensures all payments can be reviewed out of one specific place.

Any claim with a follow-up date will populate in the Claims Follow-up section of the Organization Dashboard.

  1. To access the EOB Review Queue you will need to go to Work Center and then Insurance Claims > Work Claims. 
  2. Change the Claims drop-down to Open, All and select Review Payment from the Queue filter and enter your other search parameters like Follow-up date range, as needed. Click Update to apply the filters.
  3. Next, go into each individual claim, review the payment, and choose whether to close it or follow up with the payer.
  4. To review the applied payments, click on the Claim ID.
  5. Open the Payments tab.
  6. Click on the Check Number.
  7. You have two tabs, Details and EOB:
    1. Use the Details tab to see the payment totals by line item including Billed, allowed, deductible, co-insurance, adjustments, paid amount, and patient responsibility. 
    2. Use the EOB tab to review the EOB data and ensure the payment details match. 
  8. Next, determine if the claim was paid as expected:
    • If the claim was paid as expected, we can close the claim.
      1. From the Work Claim screen, open the Workflow tab. 
      2. Click Close Claim Instance
    • If the claim was not paid or there was an issue with the payment that requires additional follow-up:
      1. From the Work Claim Screen, open the Workflow tab.
      2. Click Edit. 
      3. Update the Follow-Up Date for the claim and change any of the other claim workflow details as needed.
      4. Click Save

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