Switching: Claim Administration

An Electronic Remittance Advice is a digital version of the traditional paper Remittance to the Medical Aid. An ERA provides essential information regarding the claims that were sent and their responses, helping you to track and reconcile payments from Medical Aids.

Please Note: To access and utilise Electronic Remittance Advice (ERA) features, it is necessary to advise us that you would like to use these features. The setup for the use of ERA's is done during your install process.

• The contents of this user manual will consist of the following information:
• Search Filters
• Columns 
• Total
• Options
  
  
• This user manual will start on the ERA Management screen.

• An explanation will be given for each field and option on the ERA Batches screen:

Search Filters

Criteria used to refine the results of the information that will be displayed on the screen.

• Enter the desired information that you are looking for in the Search for a batch by MA no., batch no., or medical scheme name... field to refine the results accordingly.

• Tick the relevant Checkboxes of the options that will be considered when refining the results.

• New: New Remittances that are available for Importing.
  
• Duplicate: Shows all ERAs that have the exact same information.
• Posted: All Remittances that have been processed.
• Deleted: Shows the Remittances that have been Deleted. 
  
• Imported: All Remittances that have been Matched/Imported and are ready to be Posted.
  
  

• Select the Date range from the Date Picker according to the Dates when the ERA was captured, that you are looking for.

• From: The Date From which the results on the list will start.
• To: The Date To which the results on the list will end.
  

• Click on the Search button once all the Search Criteria have been added.

Columns

• The list is divided into the following columns:

• ID: The Number in which order the specific ERA was imported/added.
• Funder Name: The Name of the Medical Aid from whom the Remittance was received.
• MA Batch Numbers: The Reference Number that the Medical Aid allocated to the Remittance.
• Payment Date: The Date that the Payment was made.
• Import/Creation Date: The Date the ERA was Imported from Medical Aid or manually captured. 
• Import/Created By: The Name of the User that imported the Remittances.
• Status: Will indicate if the ERA is New/Imported/Duplicate.
• Type: How the Remittance was captured, via ERA/Manually.
• Total No. of Payments: The Number of Payments made from the specific Medical Aid to the Practitioner/Practice.
• Total No. of Matched Items: The Number of lines that were Matched exactly from the Payment.
• Total No. of Unresolved Payments: Payments that were not Matched correctly to Invoice lines. These Payments need manual intervention to determine why they did not match.
• Progress: Shows the Percentage of how far the ERA has imported.
• Amount Paid: The Total Amount that was paid on this specific Remittance.

Total 

The Total Amount of all ERA's will be displayed at the bottom of the screen.

Options

Additional Options that are available on the ERA Management screen.

Please Note: You will first need to Click on the desired ERA in order to access some of these options.

• Click on the Delete Selected ERA button to remove a selected ERA from the list.

• Click on the New ERA button to capture an ERA manually.
  

• For more information regarding how to manually capture an ERA, please refer to the user manual: How to Manually do an ERA.
  
  

• Click on the Import All New ERA button to import ERAs that have not yet been pulled through into the system.

Please Note: If any New ERAs have been added they will be visible on the list.

• Click on the Edit Selected ERA button to make changes to the ERA that was uploaded if necessary.

• For more information regarding How to Edit an ERA, please refer to the user manual: How to Edit an ERA

• Click on the Re-Import Selected ERA button to reload and update the ERA, if any changes have been made.