Putting Your Electronic Remittance and Centricity Practice ... · Customer is responsible for ensuring an accurate attestation is made and Virence Health does not guarantee incentive

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Putting Your Electronic Remittance and Centricity Practice Setup Into Overdrive

November 10, 2018Mark GirouardSr EDI Solution Consultant, Centricity EDI Services

2

Enhance care quality

“Centricity™ solutions help me unlock value in my organization in many ways. We use the EMR in a way that guides our staff down a path -- building rules into the software to help us. Using GE Healthcare products has actually helped us improve the [patient] wait time, and we are able to help our staff do the right thing.”

-Rhonda Draper, Ortho Northeast

©2018 Virence Health Technologies. All rights reserved.

The contents provided herein are for information purposes only. Virence Health makes no representations or warranties as to current

or future product functionality, or in any other respect, and Virence Health disclaims all liability from any reliance on the content or

information provided herein.

Customer is responsible for understanding and meeting the requirements of achieving Meaningful Use and MACRA-related payment

programs as applicable through use of HHS certified EHR technology and associated standards. Customer is responsible for

understanding applicable Virence Health documentation regarding functionality and reporting specifications, including for Meaningful

Use and MACRA-related payment programs, and for using that information to confirm the accuracy of attestation for Meaningful Use

and MACRA-related payment programs. Customer is responsible for ensuring an accurate attestation is made and Virence Health

does not guarantee incentive payments. Use of the product does not ensure customer will be eligible to receive payments.

Centricity Practice Solution v. 12.3 EHR Module and Centricity EMR v. 9.12 are ONC 2015 Edition compliant and have been certified

by Drummond Group in accordance with certifiable action criteria. For additional certification and transparency information, visit

www.gehealthcare.com/certifications.

http://www.gehealthcare.com/certifications

Executive summary

This presentation will help you:

• Increase provider efficiency by increasing the quality and number of electronic payment posting transactions.

• Strengthen financial performance by increasing the number and quality of EDI transactions, which cost a fraction of manual transactions.

Key outcomes impacted:

• Reduce manual work

• Reduce errors and increase efficiency

• Increase visibility and reporting of ERA data

Putting Your Electronic Remittance and Centricity™ Practice Setup Into Overdrive

Agenda

1. Why posting electronically is important

2. CPS setup

– Transaction column set

– Claims Response Processor

3. Centricity EDI: Improving your payment posting experience

4. Centricity EDI: ERA reports

5. Q&A

Why posting electronically is important


Estimated that only 56% of payment transactions are fully electronic.

Partially Electronic means using a payer portal to access the data electronically.

https://www.caqh.org/sites/default/files/explorations/index/report/2017-caqh-index-report.pdf


• Time and cost savings for the practice; greatest per-transaction savings opportunity at $3.69 per transaction

• 500 transactions a month = $22,140 savings per yr.

• Increases accuracy of data entry vs manual payment entry

• Automatically populates required information for secondary filing

• Quicker response from insurance companies

https://www.caqh.org/sites/default/files/explorations/index/report/2017-caqh-index-report.pdf


1158 Unique ERA connection

A lot of opportunity!

Have you checked out the Centricity EDI Payer List recently?

EDI Support can help with enrollment questions

ERA Setup in Centricity™

Practice SolutionTransaction Column Set

ERA Setup in Centricity Practice Solution

Fit together to complete the full posting picture

Transaction Column Set

Claims Response Processor Settings

ERA Setup in Centricity™ Practice Solution

• Setup a special TCS

• Associated to each insurance that is part of the remittance file

• Can be one shared by multiple insurance

• Can have a different one for a special insurance



Typical ERA TCS

• If needed change the column order here

• This is CPS’ template for you insurance

• Column order changes in payment distribution cause display issues


ERA Setup in Centricity Practice SolutionTransaction Column SetName Name type Action Action type Other Comments/Recommendations

Payment Payment Payment Payment Allow

override

Pulls from SVC03

Payment

Type

Type None Payment Displays if Allow payment type

override is checked off.

Actual

Allowed

Actual

Allowed

None AMT*B6 first; else Ins. Non Payment

Codes / Calculate Actual Allowed row

Cont.

Adj.

Adjustment Adjustment Contractual

Adjustment

- Contractual

Check box

- Allow

Override

Contractual check box creates a link

with a column of type Actual Allowed.

Only one Adj. type column can have

a Contractual check mark. (FEE-B6)

Cont.

Adj.

Type

Type None Cont. Adj. Displays if Allow Adjustment type

override is checked off.

ERA Setup in Centricity Practice SolutionTransaction Column SetName Name type Action Action

type

Other Comments/Recommendations

Deductible Deductible None Do not set an action of Transfer here. Allow the

residual column to transfer. (PR 1)

Co-

Insurance

Co-

Insurance

None Do not set an action of Transfer here. Allow the

residual column to transfer. (PR 2 or 3)

Residual Residual Transfer Add

message for

transfer

Check off

show on

statements

Once a CLP segment has posted, the insurance

balance is moved to residual. Residual looks for

another payor:

• if yes balance stays in insurance

• if no balance goes to the patient

Line Info Line

Information

None Collects line level adjudication info. needed for

billing next payor. (All CAS segments for

procedure)

Misc. adj. Type None Cont.

Adj.

Allow

Override

Checking off Allow Override will cause the Misc.

Adj. Type column to appear.


Very important to create a column with type of Actual Allowed

AMT*B6 amounts post to this column

If ‘Contractual’ on the Adj. column is checked off, then CPS links the Actual Allowed column to the Contractual Adj.:

Actual Allowed = Fee - Contractual Adj.

CAUTION: Sometimes payors include more in the B6 than just 45 info. If this is not true, then the contractual adjustment will not be just based on the 45.


Actual

Allowed


Check off ‘Contractual’ to link this to the Actual Allowed

Check off ‘Allow Adjustment Type Override’ to see the Adjustment type in the TCS

Default ERA setup does not post to the Contractual Adjustment

Contractual Adjustment = Fee – Actual Allowed


Contractual

Adj.


Plug-in is hard coded to post a reason code of 1 (e.g. PR 1) to the first deductible type column

The name field is a free text field and so cannot be used for posting logic

When posting ERA always set the action to none

An action of Transfer, will move the balance to the patient regardless if another insurance exists or not.


Deductible


Plug-ins are hard coded to post a reason code of 2 (co-insurance) and 3 (co-pay) to the first Co-Insurancetype column it finds

The name field is a free text field therefore cannot be used to manage posting

With ERA always set the action to none

With ERA, setting an action of Transfer could cause funds to be moved to the patient responsibility before their other insurance is billed


Co-Insurance


End of posting CLP remaining balances move to the residual column

Action = Transfer:

Question: Is there another payer?

– Yes = balance stays in insurance then move it to the next payor

– No = Transfer to patient responsibility

Enter a general transfer note

Check off to Show on Statements


Residual


1. Exclude if Non Adjudicated Codes

Use to stop non-adjudicated procedures from moving to the residual column then to the next payor or transferred to the patient, following a partial payment posting.

2. Exclude if Payer Take backs

Use to stop take procedure balance from moving to to the residual column then to the next payor or transferred to the patient, following the posting of a take back.


Residual


Remittance Review Front Desk

Remittance Review coding

Remittance Review Eligibility

Caution: Do not move Remittance review to the top as it will be assigned to every new visit.

Visit Owners


Only one owner per visit

The first owner encountered is the one that gets assigned to the visit

Clearinghouse setup is claim level, so it is always the first owner encountered. Don’t recommend setting up owner here.

Owners is a field in Task Manager can help with task queues.

Visit Owners


Centricity Practice Solution (CPS) does not use the Insurance Carrier’s Insurance Group for organizing like payors when processing ERA files

Payer Literal and Lowest Dot ID


What is a literal:

• Organizes like insurances – same instructions

• Identified which insurance it can post to – avoid error with literal message.

• Inactive insurance with literal is still used in setup

• Which insurance will have the posting instructions – lowest ID with literals

How payer uses them:

• ERA files can be created by LOB: PPO, HMO, Medicare Part C etc…

• Can be multiple literals for the same insurance carrier

Insurance Carrier Literals are Very Important to CPS setup



Look at ERA files with the same literal, for instance

• N1*PR*NOVITAS SOLUTIONS, INC.

Determine which insurances could be in the file

ISA*00* *00* *ZZ*12502 *29*1917860 *150213*2359*U*00501*423900437*0*P*>…

N1*PR*NOVITAS SOLUTIONS, INC.…

CLP*000045 Medicare Part B….

CLP*000059 Medicare Part B….

CLP*000150 Medicare Secondary….

CLP*000298 Medicare Part B…


The ERA file contains Medicare Part B

AND Medicare Secondary claims.

Set them up with the same Literal and TCS

ERA Setup in Centricity™ Practice SolutionPayer Literal and Lowest Dot ID

Both insurances have the same

literal…. so….

Setup both with the same TCS

Setup both with the exact literal

as it appears in the N1 segment


**DO NOT CHANGE THE DOT ID NUMBER**

CPS Assigns an ID number when the insurance is created

Two IDs: Display and Database

Same when Insurance Carrier is created

Display can be changed, Database cannot

CPS ERA uses the DB ID for ERA processing

If you change the display ID they will no longer match and you can’t easily tell which number the system is reading.



ERA setup is only on the insurance with the lowest dot ID



ISA*00* *00* *ZZ*12502 *29*1917860 *180130*2359*U*00501*423900437*0*P*>

GS*HP*12502*1917860*20180130*2359*437*X*005010X091A1

ST*835*000000281 Start of Check Details

BPR*I*98.65*C*CHK*CCP*01*081517693*DA*… DA*4427577332*20180130 Check amount and check date

TRN*1*123456789 Check number

REF*EV*1917860

DTM*405*20180130

N1*PR*NOVITAS SOLUTIONS, INC. Payer Name or in CPS Payer Literal

…

LX*1

CLP*000045*19*215.01*98.65*25.17*MB*IcnNumber*11*1 Claim information: Ticket / Status / Fee / Paid / Patient Res. / ICN

NM1*QC*1*GIROUARD*MARK****HN*123321123A

NM1*82*1******XX*Provider NPI

NM1*TT*2*BLUE CROSS BLUE SHIELD*****PI*PYR ID

MOA***MA01*MA18 Claim level Remark Codes

DTM*050*20180116

SVC*HC>99214*135*98.65**1 Service Line level information: Procedure: mod / Fee / Paid / Units

DTM*472*20180112 DOS

CAS*CO*45*9.17**253*2.01 Group and Reason codes

CAS*PR*2*25.17 Group and Reason codes

REF*LU*11

REF*6R*55 Line Item Control Number

AMT*B6*125.83 Actual Allowed

Claims Response Processor


Lowest dot ID insurance carrier

Processing Options

Claim Level codes or CLP02

Claim Level MIA and MOA Medicare Remark codes

For each setup you must chose one or the other

These codes are setup in the clearinghouse: e.g.

CLP02: 4, 19, 20, 21 OR

MIA or MOA: MA18, MA07



Post $0 Amounts For:

$0 is an exception and must be selected

$0 Payment is required for secondary filing. Not selecting it will cause them to reject.

Copay, Deductible and Sanction have no known impact.



Post $0 Amounts For:

$0 Actual Allowed has a big impact

RE: Actual Allowed = FEE – Contractual Adj

Posting a $0 Actual Allowed = 100% Write Off

CAUTION: Understand if this is appropriate for your business before selecting it.

Most provider offices do not select this setting.



If Actual Allowed Differs from Allowed:

Used to manage differences in allowed amounts between the payor and your CPS setup

• Recommend to Log in Remittance Report File

• You can select Reject Visit

• You can assign an owner

– e.g. Remittance Allowable



Procedure Code Bundling/Unbundling:

CPS can post some bundling situations

Check off Ignore SVC06 and Post Payment

Assign an owner for workflow follow up if desired



Post Actual Allowed for Primary Insurance Carrier Only

Select Post Actual Allowed for Primary Ins Carrier only

• Actual Allowed triggers the Contractual Adj.Usually we only adjust on a primary payment.

• Do not select if you want an additional adj on secondary (e.g. some Medicaid payers)



Ignore Line Item Control Number

Do NOT select as a default.

CPS uses it to find a match to a procedure for posting a payment

Payment matching is done one of two ways:

1. Line Item Control Number sent in 837 returned in 835

2. The ERA information is an exact match to the visit’s


Procedure ALL Modifiers DOS Units Fee


Ignore Line Item Control Number Checked

AND IF the line item control number is returned

THEN then the payment will post based only on the number.

AND IF the Line Item Control Number is not a returned

THEN the payment will post only if there is an exact match to; procedure, modifier, DOS, units, fee.

Ignore Line Item Control Number UNChecked:

The payor returns a different Line Item Control Number in the 835 than what was sent in 837



Override Standard Payer Name:

List name of the insurance carrier with the lowest ID is recorded as the paying insurance

In this case, all payments linked to payor literal NOVITAS SOLUTIONS, INC. would have Medicare Secondary as the payor.

Use the override property to enter Medicare.



Non Payment Codes Action: Ignore

• Everything will post; payment, adjustments, line info, etc..

• The balance remaining after posting will not get put into the residual column

• Reject Visit property will not affect the residual column

• E.g. used to process partial payments



Non Payment Codes Action: None

• Everything will post, payment, adjustments, line info, etc..

• The balance remaining after posting willget put into the residual column

• Setting Reject Visit with an action of none will stop all balances in the residual column from transferring

• Used to stop the full claim and allow it to be worked



Non Payment Codes Action: Adjustment

• Always takes an adjustment.

• Needs an Action Type to be associated with it

• Do not use if a judgment call is needed. Otherwise use an action of None & Reject Visit to be reviewed.

• CPS will auto create an adj. column if there isn’t one in the TCS. No adj. type will display but DB will capture it.

e.g. Sequestration for Medicare



Reject Visit

• When the action is None, this setting will stop the Residual column from completing the action of transfer

• Visit will be in a Filed Rejected status

• Recommend to assign an owner to the visit

• Different codes can be setup with different owners

• Two different denial codes setup with different owners will have the first owner encountered applied to the visit.



Ignore Actual Allowed(B6)

RE: Contractual Adj. = Fee – Actual Allowed

Payors do not always include all expected adj. into the actual allowed. Here is an example where we must ignore the payor’s Actual Allowed

• Medicare sometimes returns two CO 45s on one procedure, but the actual allowed only includes one

• Ignoring the B6 and calculate on all 45’s will take the correct adj.

This setting always uses the Calculate Actual Allowed setting



Calculate Actual Allowed

• Plug-in will post the Actual Allowed then the contractual Adjustment is taken

• Sometimes the payor will not return the B6 Actual Allowed, so we need to calculate it

• The Plug-in will favor the B6. IF there is no B6 then the plug-in will look for this row to calculate the Actual Allowed, which then takes the adjustment.



Non Payment Simple Setup

• Don’t want to assign special owners to different denial codes

• Don’t want to research all the denial codes

Different from traditional setup

• All row changed to handle the denials

• Need to setup the codes received with payments

• No Risk of balances going to patient because we didn’t setup a group code

Claims Response Processor Best Practice


All Row ** CHANGE IN BEST PRACTICE**

Used for processing most reason codes. There are more denials than payment codes, so use it for handling denials.

Exception rows

Use for exception to denials: Payments, Adjustments, Transfers.

Rules:

Limit of 10 codes per line with a like action; no duplicate codes

Comma separated with no spaces

Assign an action

Assign an owner when necessary

Payment row always ends with a comma



All Row

The all row will be used to catch all denials we want to review

Check off Reject Visit

Change owner to Remittance Review



New Exception Row to include:

• 1,2,3 Deductible, Co-Insurance and Co-Pay

• 23 amount is reduced due to impact of prior payer(s)

• Make sure the last item on the line is a comma with nothing after it. This takes care of the claims that paid in full without ANY CAS segment

• Others I’ve seen: PR 96 for non covered or PR 45 for contractual. Probably out of network based on PR.

• Anything the you purposely want the patient to be responsible for



Create these rows to look like what the old All Row used to look like:

• Action of None

• No property checked off

• No owner selected

Do setup the 1,2,3,23, row

+ any other code you want the patient to be responsible for.. maybe CO 96.

Always end the row with comma.



More Elaborate Setup of Non Payment Codes

Do want to assign special owners to different denial codes

Similar to Simple setup: All, 45, Adjustment (253) rows

Differences from Simple Setup

All row owner might be change to Remittance Review Code Not Setup

More Exception Rows to handle different owners for different denials



Create an Exception Row for those Reason Codes you want assigned to a special owner

Each owner to have its own exception row

If you have a row for ALL denials with special owners, then you’ll want the all row to have an owner of Remittance Review Code Not Setup.


CPS Task Manager

CPS Task Manager

Benefits of using Task Manager

• Ability to create work queues for user

• Display tasks that fix specific criteria

– use owners selected in ERA setup with visit status of Filed Rejected

• Run the queue as needed to update the tasks

• Run reports:

– Queue Volume

– Task History

– Task Volume by User

CPS Task ManagerReports

Three Different Reports for Task Manager

Go to Reports Module

Select Administrative

Expand on Productivity and Management Reports

• Queue Volume

• Task History

• Task Volume by User

CPS Task Manager

1 Select Build Queues

Building a Task Queue

2 Type in a queue name

3 Assign queue user

and auto assign

tasks to users

4 Add in the Queue

criteria of:• Visit Owner as

appropriate

• Visit status of

Filed Rejected

6 Run Queue

5 Preview and

Save Queue

1

2

3

4

5 56

CPS Task ManagerWorking Tasks

• Running the Queue Query to update items

• Click on ‘My Tasks’ for list of claims to work

• Double Click on rows to open Visit details

• Fix issue: Visit Status and or Visit Owner will update

• User can right click on row and change task status to complete and it disappears.

CPS Task ManagerWorking Tasks

Select Complete

Task

Task automatically

is removed

In queue section

you can view

competed tasks

CPS Task Manager

Queue Volume report:

• number of tasks in the queue

• average number of assigned days

• total visit balance

This report is useful for identifying high dollar queues, managing group workload, and assessing productivity through turnaround time.

Reports

CPS Task Manager

Task History report:

• Task history grouped by ticket number or patient

• Queue entry date and completion date,

• When and to whom the task was assigned

• Task status when it was modified

• Status of the corresponding visit whenever the user modified the task.

This report is useful for troubleshooting a workflow for a specific patient or visit.

Reports

CPS Task Manager

Task Volume report:

• Tasks assigned to a user within a specific date range

• Balances for the associated visits at the time the task was assigned.

This report is useful to track your user’s workload and age of their tasks.

Reports

Centricity EDI: Improving your payment posting experience

Centricity™ EDI

• Limitations of ERA posting:

• Need to post back to a CPT code

• Cannot post claim level payment

• Some bundling situations cannot be posted electronically

• Poor data from the payor Centricity EDI can sometimes help!

Improving your payment posting experience

Centricity™ EDI

Issue:

Order of claims in ERA can be different from paper EOB

e.g. 835 is by ticket number while paper is by Insured Last Name.

While reviewing Transactions Management, it helps to have the data in order.

Solution:

Centricity EDI can resort the 835 data alphabetically using the insured’s last name.

Only the first letter of the last name is sorted.


Centricity™ EDI

Issue: PA Medicaid ERA will not post.

Payor returns a Claim level Remark Code segment without a remark code.

CPS plug in is expecting a remark code and stops processing the remit file.

▪ CLP*430908-01*1*175.00*54.25**MC*ICNUMBER*11

▪ NM1*QC*1*LName*Fname****MR*INSURED ID

▪ MOA**54.25 No Remark code, just a $ value

Solution:

Centricity EDI will remove the claim level remark code when there is no remark code present. The claim level remark amount is not needed by the provider and is ignored in posting the remittance. The resulting ERA file will process.


Centricity™ EDI

Issue: One payer literal, two diff posting instructions

Health Plan Partners use the same payer literal for both Medicare and Medicaid product.

Provider office needed to use different adjustment types: Medicare Contractual and Medicaid Contractual

Since there is one Payer Literal, there is

• One set of instructions

• One Transaction Column set

• Only one adjustment type could be used


Centricity™ EDI

Researched:

• Files were either all Medicare or all Medicaid…. Claims types were not mixed in an ERA file

• Medicare insured IDs were 7 digits long

• Medicaid insured IDs were 9 digits long

Solution:

Centricity EDI created a mapping based on the 1st Insured ID. If it was equal to 7 digits then we would add MC to the end of the literal name.

Medicare and Medicaid now have unique literals. Separate instructions could be setup allowing the correct adj type to be used.


Centricity™ EDI

Issue: Some multiple unit claims are being paid by unit

For PT (CPT 97XXX), UHC and Aetna will split out multiple units into multiple payment lines.

This cannot be posted back in CPS because there is only one CPT not 2 or 3 or more…

Each payment someone would have to calculate the total paid, adj, co pay etc.. and enter the amounts manually.

***working on same solution for Mod 50 logic.


Centricity™ EDI

Billed 97110 Line item control number 123456 for 3 units

UHC paid

CLP*275915-01*1*312.72*87.81*30*HM*ICNumber*11*1

…

SVC*HC>97110*78.03*32.11**1**3

DTM*472*20180905

CAS*CO*45*41.87

CAS*PR*3*4.05

REF*6R*123456

AMT*B6*36.16

LQ*HE*N59

SVC*HC>97110*156.06*55.7**2**3

DTM*472*20180905

CAS*CO*45*64.48**59*35.88

REF*6R*123456

AMT*B6*55.7

LQ*HE*N59

…


CLP should one SVC for 97110:

Fee 156.06+78.03=234.09

Paid 32.11+55.7=87.81

CO 45 64.48+41.87=106.35

PR 3 4.05

CO 59 35.88

B6 55.7+36.16=91.86

Currently users have to manually add up

all these amounts and post by hand.

CPS will not post 1 then 2 units, they don’t

exist in CPS that way.

Centricity™ EDI

Solution:

• Within each CLP segment, look for duplicate REF*6R numbers

• If duplicate found, roll up amount to make 1 entry:

– fee, paid, units, similar Reason Code, Allowed amount AMT*B6

• Include all unique reason codes

• Setup at payor ID level

Centricity EDI mapping:CLP*275915-01*1*312.72*87.81*30*HM*ICNumber*11*1..SVC*HC>97110*234.09*87.81**3**3DTM*472*20180905CAS*CO*45*106.35CAS*PR*3*4.05CAS*CO*59*35.88REF*6R*123456AMT*B6*91.86


This will post back correctly in CPS

Centricity™ EDI ERA Reports

Issue: Shared TIN so cannot enroll for ERAs

Are you part of a merger or acquisition?

Many payors will return ERA files back based on TIN… Who will get the files? Are you posting by hand because you can’t get the ERA file?

Solution:

Centricity EDI can split the 835 file out based on unique Ticket numbers

Centricity EDI can setup an SFTP connection with your organization to

Deliver your ERA file back to CPS

Deliver the other entities ERA file back through the SFTP connection

Cull out the appropriate claims and redo check totals or provide adjustment

Centricity EDI ERA Reports


Use Centricity EDI report Remittance Trend For Last 12 Month for all Literals to be setup in CPS

Remittance Trend

Filter out the contractual and other adjustments like OA 23

Change the drill down order to be

• Category

• Payer

• Scenario

All denials will come up in categories

OCT 18 2018: 23 reassigned to Contractual AND 18 reassigned to Other

Centricity™ EDI ERA ReportsRemit Summary

Centricity™ EDI ERA ReportsRemit SummaryList of Group and Reason Codes to setup in CPS by Payor Literal


Create a report to show top denials

Change drill down to show scenario then procedure

Sort by Billed Amount

OCT 18 2018: 23 reassigned to Contractual AND 18 reassigned to Other

Remit Summary

Centricity™ EDI ERA ReportsRemittance Reconciliation Summary

Navigation is from eStatus tab

Bottom reports are remittance

Remit Reconciliation Summary Reports

• Remittance Reconciliation Summary


Selecting the EOB file name or icon will open an EOB created from the 835


Centricity™ EDI ERA ReportsRemit Check Summary

Are you missing an ERA file?

Here is how to requeue it yourself.

Centricity™ EDI ERA ReportsRemit Check Summary

List of $0 ERA files to post without waiting to be reconciled to bank deposits


Make a list of ERA files received In EDI Response Management with $0 to make sure they’ve been posted.

e.g. of $0 ERA file BPR segment

BPR*H*0*C*NON************20180926 key data indicating $0 file

e.g. of non $0 ERA file BPR segment

BPR*I*50045.01*C*ACH*CCP*01*123456789*DA*21013321017292*987987987**01*061000104*DA**20180927 this file was not $0.

CPS Search


Search in EDI Response Management for files that contain:

• Clearinghouse = Centricity

• Select an appropriate date range

• Search for files containing the following text = *0*C*NON*

• Leave Processed Status = Not Processed

This will bring up a list of all $0 remits.

Remits that match this search can be posted without being bank reconciled

CPS Search


Deposit reports are downloaded daily from the bank, usually in Excel or .csv format…

…and matched against ERA reports or remit posting report….

Payment Reconciliation

date amt

8/23/2017 2473.31 * ELECTRONIC CHECK DEPOSIT

8/23/2017 11184.56 * NORIDIAN AZUTMT HCCLAIMPMT 17078784821 1545388986301 TRN*1*8896754661931*1450173185~ 64502345173185 1588986301 R00000091004550445238

8/23/2017 7804.08 * NORIDIAN DMEMAC HCCLAIMPMT 64178982550007 TRN*1*04400544560032337120*1450173185~ 7450173185 6419820007 R00000091004550445241

8/23/2017 6352.74 * NORIDIAN AZUTMT HCCLAIMPMT 1670821 1770805590 TRN*1*88967234521930*1450173185~ 6450173185 1770805590 R00000091004550445237

8/23/2017 5364.81 * Banner Physician HCCLAIMPMT XXXXX9251 TRN*1*08100060545548368950*1860662152\ 9000004108 101609251 R00000091004550445242

Date ACH/trace number Paid to Provider Paid By

08232017 123484234 2473.31 Provider Automation Lockbox

08232017 8896754661931 11184.56 Noridian

08232017 08100060545548368950 5364.81 Banner

08232017 04400544560032337120 7804.08 Noridian

Centricity™ EDI ERA ReportsPayment Reconciliation

Centricity™ EDI ERA ReportsPayment Reconciliation

Helping you achieve the outcomes that matter most to you

Improved Provider Efficiency

• Reduce the time it takes your organization to post payor EOB

• Increase the number of successful electronically posted payments by using Centricity EDI’s custom mapping

• Reduce the number of payments touched by making sure your ERA setup is optimal

• Use Centricity EDI to upload and parse out ERA files from your parent organization, that you could post with before.

Strengthened Financial Performance

• CAQH estimates that it costs $3.69 per ERA transaction more if posed by hand.

• CAQH estimates that on average only 56% of payment posting is done electronically.

• Use Centricity EDI report to find $0 remit and post them as soon as possible. This will ensure patient balances, and denied claims are applied and worked timely.

Action items

Centricity EDI Administrator user

• Review Standard User access to website

Billing Manager

• Review existing ERA setup

• Identify opportunities for new ERA connections

• Work with EDI Support on enrolling new payors and setting access to Remit Reconciliation

• If you have a shared TIN, contact EDI Support to get parent organizations remits process to CPS

• Contact Sales for demo to Payment Reconciliation

Training department head

• Deliver training session on use Centricity EDI reports

Thank you!

Mark Girouard

Sr EDI Solutions Consultant

[email protected]

802-859-6885

mailto:[email protected]

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Putting Your Electronic Remittance and Centricity Practice ... · Customer is responsible for ensuring an accurate attestation is made and Virence Health does not guarantee incentive

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