ERAs (835) Claim File Processing
An Electronic Remittance Advice (ERAs), known as 835, is an electronic version of the Provider Explanation of Benefits (EOB). The 835 represents an electronic breakdown of the reimbursement decisions from the Payer. 835 files are used by practices, facilities, and billing companies to auto-post claim payments into practice management systems.
The HHAeXchange system can apply the 835 data directly into the Provider’s accounts receivables, via SFTP if the Provider shares the 835 files via HHAeXchange. Payments can also be posted manually in the Provider Portal.
Refer to the SFTP Client Configuration topic for details and instructions on how to set up an SFTP account.
Providers receive instructions from HHAeXchange on how to retrieve 835s from the Payer; otherwise, Providers must contact the Payer directly to enroll for ERAs.
SFTP applications are divided into two sections. Once connected, files display as follows:
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The left-side displays the personal directory, desktop, public drive One Drive, etc.
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The right-side displays the Contract Remittance folders created by HHAeXchange.
Contract folders are located on the right side. Go to Inbox > Remittance Folder > Contract Folders.
Locate the saved 835 files that appear in the left window and drag them to the appropriate Contract folder on the right window. The system only processes 835 files that are x12/txt format.
The HHAeXchange system runs an overnight process that transfers 835 files to the Provider Portal and applies payments to corresponding visits in the system.
Providers can view payment details from the overnight file process to include rejections and/or invalid amounts for each contract via the Cash Payment module Billing > Cash Payment > E-Remittances.
Checks are not automatically posted. The Provider must review and manually post payments.
Go to the Payments and Refunds page Billing > Cash Payment > Payments and Refunds and search for the check numbers that have been uploaded through the SFTP. Once located, review the check date, deposit date, check number, check amount, and the posted payments.
