The world of healthcare billing is a complex reign where accuracy is of utmost importance. However, maintaining accuracy is a tough call which requires immense expertise in the field. ERA is an effective way of streamlining communication between medical providers and insurance coverage providers.
If you are looking for medical billing services in California this blog will guide you through all the elements of Electronic Remittance Advice.
What Is ERA?
ERA is a form of electronic communication that eliminates the need for paper EOB. ERA contains the information about the final status, any adjustment made to the billed amount or whether the claim was paid or denied. It is one of the RCM services that can enhance the revenue of your organization.
Posting large amounts of EOBs is very time consuming which increases the cost. Adding to the inefficient processing and high administrative costs, going through paper archives to investigate the claims results in payment posting errors and inaccurate accounts receivable.
Having a full-fledged ERA process helps improve communication and comprehension of a patient’s health coverage, payments, and denials from the insurance payer.
How ERA Works?
A health insurer sends an electronic remittance advice file to the healthcare provider following a claim. This electronic exchange of data provides and Explanation of Benefits to care providers about the decisions made about the claims submitted for payment.
The electronic remittance advice borderlines the adjustments and payments a health plan has made to charges from the provider. If there is a denial it must explain why the claim was denied.
Various factors such as benefit coverage, co-insurance, expected copays, contract agreements and secondary payers are needed to make these adjustments.
Importance of ERA in Streamlining Payments
Electronic Remittance Advice in medical billing plays a major role for payment processing in the world of healthcare. ERA healthcare Claims and payments are significantly faster and more efficient when it is managed electronically.
It offers other benefits such as:
- Reduced errors due to automated processes
- Reduced need for manual entry
- Saves employee’s time
- Fastens account reconciliation
Benefits & Advantages of ERAs
The advantages of using Electronic Remittance Advice in medical billing includes the following:
- Error Reduction
- Automated Payment Posting
- Improved financial management accuracy
ERA tools help providers accumulate data that can analyze all the aspects of an organization’s finances, including claim payments, denials, identifying payment trends, and optimizing opportunities for improving revenue of an organization. Implementing ERA in your practice in medical billing increases the revenue flow and maintains stability of the organization.
Understanding the Components of an ERA
ERA healthcare applications are very complex. Understanding the process eliminates the risk so a period of rigorous training and education is very important. Organizations that train their employees about the use of ERA achieve ultimate cost and time saving benefits.
However, to do this, understanding the structure of ERA is very important. The major components of an ERA are as follows:
- Heading Information: This area includes EFT numbers, payer tax ID information, total payable amount, payment method data, as well as payer identification.
- Claim Details: the next section has more details about the claim and account number, the current claim status, submitted claims, payments, and patient identification information. It also includes all the details that can change over time due to the approval or denial of claims.
- Payment Specifics: This element lists the payment details including where the account stands.
- Remark Codes: This element allows any detailed notes and insights necessary.
How ERA Improves Revenue Healthcare Organizations
The implementation of ERA has numerous benefits. The most important factor is automated posting which eliminates the risk of errors. This also helps with better oversight and solutions when discrepancies are found.
Organizations can use their valuable data provided by these tools to not just meet patient’s needs but also to look for insights that can improve your overall outcomes. When ERA is used properly it can improve the claim submission process while maximizing the reimbursements of healthcare organizations.
Common Challenges in ERA
There are a few challenges while implementing ERA in your process, but it is the same when you introduce any new process to your operation. It is somewhat a new thing that you will have to teach your employees about.
Another concern occurs within organizations using multiple software products. If the tool cannot be integrated, this will lead to higher costs and make the process more time consuming.
A lot of organizations worry about data security and privacy standards. ERA does create new ways to share information but when implemented correctly, it can minimize the risk of HIPAA violations or other compliance risks.
ERA software can be versatile and when it is properly evaluated, selected, adopted and used by employees, it can enhance your workflow integration providing remarkable improvements in data security. This ensures efficient and secure ERA processing.
How to Implement ERA in Your Process?
Integrating ERA in your practice can be done efficiently by selecting the ERA software you wish to use. The staff can take some steps to implement ERA:
- Evaluate your process to find any integration limits
- Decide an appropriate software your organization needs to tackle current challenges
- Tarin your staff on how to use the platform
- Establish key performance indicators and begin monitoring them
- Work towards diminishing any gaps that exist in the timeline
- Once your practice has the potential to offer seamless integration, ERA can start working on creating efficient billing strategies and optimizing revenue instantly.
ERA vs Paper Based Billing
While making the decision to move towards ERA healthcare system, organizations need to consider the difference it will create in your operations, especially if you are using paper-based billing.
You will see a significant reduction in your administrative costs as the efforts needed to collect or update paper checks will not be needed.
Additionally, it will reduce the errors and payment reconciliation as it will be streamlined for a faster and efficient process.
How To Choose the Right ERA Software?
Now that you know the importance of ERA, let’s learn about the things you must look for in a software:
- The software must be compatible with the existing billing systems and processes.
- It should support the payer formats you are currently using
- It should have a user-friendly design
- Determine the security levels and risk factors
- It should have a good vendor support
However, if you think this is a big hassle for you, you can always go for outsourcing your medical practice. Having a medical billing professional is of great help when you are looking for a good ERA process.
Unify Healthcare Services also offers ERA service with their immense array of services. They have an expert team of professionals who can take care of all your medical billing and coding needs, along with ERA. Getting help from professionals can do wonders for your organization that involves financial improvements and administrative tasks.
Unify healthcare services envisions simplifying medical billing for every healthcare practice so the providers can have more time to focus on patient care. We do not provide just medical billing services; we provide mental peace.
