ERAs that power faster, more efficient billing

Insurance billing isn’t getting any simpler — but the tools available to make it faster and more accurate keep improving. In this month’s MP Business Services mini class, the MPBS team sat down to walk practices through one of the most underused efficiency tools in revenue cycle management: Electronic Remittance Advices (ERAs).

If your office is still manually pulling EOBs from insurance portals and keying in payments line by line, this one’s for you.

What Is an ERA, Exactly?

An ERA (Electronic Remittance Advice) is simply your EOB (Explanation of Benefits) in electronic form. It contains the same information you’d get on a paper or portal-based EOB — payer name, check/trace number, patient name, procedure codes, billed and allowed amounts, deductible/coinsurance/copay, disallowed amounts, payment, and reason codes — just delivered electronically and ready to post directly into your practice management software.

ERA vs. EFT: A Common Point of Confusion

One mix-up we hear often: Aren’t ERAs and EFTs the same thing? Not quite — and the distinction matters.

• EFT (Electronic Funds Transfer) is how you receive the actual payment into your bank account.
• ERA (Electronic Remittance Advice) is the electronic version of the explanation behind that payment.

You can have one without the other — for example, a remittance advice that arrives electronically while the actual payment still comes by mail check.

How to Sign Up for ERAs

Getting set up is more straightforward than most offices expect:

1. Enroll payer by payer. If your practice isn’t currently receiving ERAs, your software vendor is the starting point. Payer enrollment typically happens in the clearinghouse’s portal. Aim to sign up for ERAs with each insurance company you bill.
2. Call the insurance company directly if needed. If the electronic payer ID isn’t printed on the patient’s insurance card, a quick call to the payer (e.g., United Healthcare) will get you the five-digit payer ID and next steps for enrollment.
3. Lean on your software company. Your practice management software provider — like MacPractice — can help point you toward the right clearinghouse and enrollment process.

Working with ERAs Inside MacPractice

Once enrolled and ERAs are flowing into your account, here’s what to expect in MacPractice:

• Where to find them: Managers → ERA Manager (left sidebar).
• What’s on the ERA: Payer name, date, check/trace number, delivery method (clearinghouse vs. check), patient name, account number, policy number, ICN, procedure code, date of service, billed/allowed amounts, patient responsibility, disallowed amount, payment, reason codes, and remark codes for denials.
• “No Match for Claim”: If an ERA shows this, it typically means the original claim was submitted on paper rather than electronically — so there’s no matching electronic claim for the system to tie the payment to. In that case, you’ll post the payment manually.
• Posting payments: When a claim was submitted electronically and the ERA matches it, simply click Post Payment. Always keep the “Use EOB” column box checked — this auto-populates the check number, amount, and date directly from the electronic remittance.

Most practice management software offers some level of integrated ERA support — but the specific workflow varies. If you’re using a different system, check your software’s documentation to make sure you’re following the optimal posting process for that platform.

A Best Practice Worth Adopting: Match Your Columns to the EOB

Align your posting columns to mirror your EOB’s layout — this keeps your data entry consistent and makes it far easier to catch mismatches or missing information at a glance.

Why this matters: Missing or misaligned fields at the time of posting can cause downstream problems — claims rejecting at the clearinghouse, secondary claims failing to process, or having to track down the original EOB later to fill in a gap. For example, if a primary payment is posted without the reason code (e.g., CO45) and ICN number, and a patient later reveals a secondary insurance you didn’t know about, that secondary claim will reject because the primary claim’s reason code and ICN are required for it to process cleanly. Populating these fields at the time of primary posting saves a scramble later.

Why It’s Worth Making the Switch

Manually gathering EOBs from multiple insurance portals and hand-keying the data is a significant time drain — one that adds up to real staff hours every week. ERAs largely eliminate that work by:

• Auto-populating payment data, reducing manual keystrokes and the errors that come with them (miskeyed or transposed numbers)
• Speeding up payment turnaround compared to waiting on mailed checks and manually retrieved EOBs
• Reducing billing fees relative to staff time — most ERAs carry a small per-transaction fee, but it’s typically far less costly than the staff hours spent manually processing paper EOBs

Not every payer offers ERAs, but the majority now do. If a payer you work with doesn’t currently support ERAs, it’s worth checking back periodically to see new ones that become available.

Ready to put this into action? Here’s where to start:

1. Audit which payers your office is currently receiving ERAs from — and which ones you’re still manually processing.
2. Contact your practice software vendor for guidance on enrolling in ERAs for any outstanding payers.
3. Review your ERA process. If you can, adjust the column setup to mirror the order on the EOB layout.

👉 MP Business Services helps practices with billing and revenue cycle workflows. Have questions about ERAs or want help streamlining your payment processing? Contact the team at [email protected].