ERA Worklist Tab

ERA Worklist

The ERA worklist is where all electronic remittance assays (ERA) will flow to from the Change Healthcare clearinghouse.

Navigation:

To navigate to the ERA Worklist screen, click on the EOB/ERA tab next to reports that appears in every screen of the Accounting section. 

The ERA worklist will display all ERAs that need to be worked as well as those that have been posted. At the top of the ERA list, there are filters to search for ERAs.

1. Payer Name - sorts list by payer name

2. ERA Received Date - sorts list by ERAs received on the date selected

3. Payment ID/Method - enter the check or EFT number to find a specific ERA

4. Deposit Date - sorts list by the date that money was deposited into bank

5. Status - filters by status of the ERAs. The list will default to New ERAs that need to be reviewed.

   1. All - provides a list of all ERAs regardless of the status.

   2. New - filters only new ERAs that have not been approved or posted.

   3. Approved - filters ERAs that have been approved but not posted.

   4. Posted - filters ERAs that have been approved and posted to the patient accounts.

   5. Discarded - filters ERAs that have been deleted out of the system.

1. The checkboxes in the last column allow you to select various ERAs that have already been reviewed and approve or approve and post them in one action. Select the ERAs you want to bulk approve/approve and post.

2. Click on either the Approve or Approve and Post button. If you use a two-step process for working your ERAs, select Approve. If you do not have a two-step process for working ERAs, then select Approve and Post. 

3. To edit an ERA, click the pencil icon.

4. To delete/discard an ERA, click the trash can icon. 

**We recommend discarding ERAs if 1) a manual EOB was entered 2) if everything came back denied or 3) if the entire ERA is duplicate claims (OA-18 reason code)**

ERA Review Screen

After clicking on the pencil icon of the ERA you want to review, the above screen will appear.

At the top of the screen, the ERA date will be listed. The ERA Date is the date that the ERA came into Artisan.

Total - the total amount of the entire ERA. This will show the total for any split claims that were sent through another system. You can hand post those claims to the other system.

Artisan Total - the amount of the ERA that is being sent to Artisan.

Check Number - check or electronic funds transfer (EFT) number for the ERA

Payer - insurance company where these claims were submitted

Deposit Date - this is the date the money was deposited into the bank. This is a required field before making changes or approving the ERA.

View PDF - allows you to see a PDF version of the ERA. This will open a separate window as displayed below.

For ERAs containing multiple patients and dates of service, green boxes at the top of the page will appear with the patient’s name and date of service (if the ERA contained more than 1 date of service for that patient). 

Click on the patient’s name in the green button and this will bring up their ERA view for that specific date of service.

Reviewing ERAs

1. Patient - Clicking on the patient’s name will bring you into the patient’s invoice summary.

2. DOS - Click on the DOS to jump to that specific date of service in the patient’s invoice summary screen.

3. Invoice Notes - any invoice notes entered on the original claim will display here

When reviewing the claim, if you agree with all of the adjustments and payments for each date of service, click APPROVE or APPROVE AND POST.

If you do not agree with the adjustments for a single line item or the entire date of service, you will want to utilize the Adjustment Action dropdown options. Adjustment Actions will not post what is listed on the ERA. 

IMPORTANT NOTE: 

The adjustment actions should ONLY be used when you want to override what the ERA reflects.

Transfer to Patient Account - does not accept the adjustments or payments and moves the responsibility to the patient. This action will also change the Status of the Invoice date to “Patient Responsibility”

Keep Insurance Responsibility - does not accept the adjustment or payments on the ERA. Keeps the money in the insurance responsibility column. This action will change the status of the invoice to ‘ERA Received’ and the ERA will be placed in the ERA Worklist snapshot so you can come back and work it later on.

Secondary Insurances

1. Each ERA will list the Primary Insurance, and if applicable, the Secondary Insurance. This will allow the payment poster to know whether to utilize the Forward to Secondary Adjustment action.

2. Utilize the Forward to Secondary Adjustment action for the adjudication to the secondary insurance. This action will not take the adjustment on the line as the adjustment needs to stay in the insurance AR. This action will record the adjustment to show the secondary payer that an adjustment exists in the primary claim.

Once the ERA is posted, it will live under the POSTED status. Clicking on the eyeball icon will allow you to view the ERA, but you will not be able to make any further changes. The green checkmark indicates that the ERA was posted.

**All manuals are compliant with HIPAA regulations.  No patient information has been released.  All screenshots above were taken from a test clinic with fake patient information.