ERA 835 Electronic Payments

Start to finish – Instructions for using ERA 835 Electronic Payments in ChiroPulse365.

Step 1 – Sign up with your clearing house or insurance carrier to receive ERA 835 files. This entails filling out a few forms which can be obtained from your carrier/clearinghouse. The process takes anywhere from 2-8 weeks. Please note that most clearinghouses charge for this service so it may be beneficial to contact your insurance carrier directly to find out how to receive their ERA’s at no additional cost.

Step 2 – Enter the Payor ID and 835 Payer ID for each insurance carrier.

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Step 3 – Once you have received an ERA 835  file download and save the file to your server computer in the pulseSQL/EDI/835 directory. Please note that each time you receive an ERA 835 file you will need to download and save it in the same directory. The program will move the file once it is imported to a processed folder and keep track so that the user doesn’t import the same file twice.

Step 4 – Open ChiroPulse365 and go to the My Office tab. Click on Electronic Payments under add-ons and extras.

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  • Select payment file location – Make sure the file directory matches where you saved the files in Step 2. The file directory should be set to pulseSQL/EDI/835 on your server’s computer so that anyone using ChiroPulse365 can work with the same files without confusion.
  • Select the ERA to import by clicking on the file and clicking import selected file.

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Step 5 – With the file now imported you are now ready to process the file by double clicking on the entry listed or clicking the view and process button. Another window will open with all the procedures for each patient listed as well as provider information, payer information and payment information.

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capture_008_25062016_115005Step 6 – Click on the continue and edit file button.

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Step 7

ChiroPulse will attempt to auto match the line items and in addition splits the ERA into payments and non-payments. The majority of times the amount of errors will be zero but if any errors are present they must be fixed prior to moving forward with the ERA.  Typically the matches are needed when the office is using a clearinghouse. The majority of the matches needed are either patient name or insurance carrier name. Tip 1 – To reduce the amount of matching that needs to be done make sure the insurance carrier is named in ChiroPulse365 the way it is received in the ERA. Tip 2 – The payer ID that you use to send through your clearninghouse may be different than what is received via the ERA. Make sure you enter both into Chiropulse365 prior to importing an ERA.

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Step 8 – Click the continue and apply to ledger button.

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Step 9 – Next you will see a list of each patient with the corresponding procedure codes and the amount of the line item payments. Click on the apply to ledger button to have them imported into ChiroPulse365.

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ChiroPulse365 gives you one more prompt to make sure you want to move forward.

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Step 10 – Click Yes to allow the program to process the payments.

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As the payments are processing you will see this window:

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When the ERA is finished processing you will see this window:

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Step 11 – You can print a list of all the CPT’s that were entered by pressing the print button after completion to compare it to the paper EOMB if you chose.