Thie following describes how to process electronic remittance advices (ERAs). In the healthcare industry, the terms electronic remittance advice (ERA) and electronic remittance notification (ERN) are used interchangeably. They both refer to a text file formatted using the X12 835 standard as mandated by HIPAA. Throughout Insight, including this document, the acronym ERA is used.
Before you can process ERA files in Insight Billing, enrollments for ERA must be completed with your payers. If you use a trading partner, you may need to go through the trading partner enrollment process. If you send claims direct to payers, you will need to enroll directly with payers.
To process ERA files, you must set up locations for storing the ERA files you download from trading partners and for the archive files that Insight creates from the ERA files (called the archive folder). Setting up both of these locations is described in this section. In most cases, these locations are already set up. If so, you can skip this section.