ERA/EFT

Electronic Remittance Advice and Electronic Funds Transfer — the electronic payment notification and direct deposit system used by payers to pay providers.

ERA and EFT work together to replace paper checks and paper Explanation of Benefits statements. EFT deposits the payment directly into your bank account. ERA sends the electronic remittance detail showing exactly which claims were paid, how much, and any adjustments or denials. Setting up ERA/EFT with each payer is a separate enrollment process from credentialing, but they are closely related. You typically set up EFT and ERA after your credentialing is approved and your enrollment is active. Some payers allow you to set up EFT/ERA during the credentialing process so payments start flowing electronically as soon as you are live. EFT enrollment requires your banking information: bank name, routing number, account number, and account type. Payers send a test transaction to verify the account before activating electronic payments. ERA enrollment routes your electronic remittance files to your clearinghouse or practice management system, where they can be automatically posted against your claims. The benefits of ERA/EFT are significant. Paper checks take days to arrive and need to be manually deposited. EFT hits your account in one to two business days. Paper EOBs need to be manually reviewed and posted. ERAs can be auto-posted by your billing system, saving hours of staff time per week. Most payers now encourage or require ERA/EFT enrollment. CMS requires all Medicare payments to be made via EFT unless the provider requests an exception. Some commercial payers add small fees for paper check processing to incentivize electronic payment adoption. When you set up ERA/EFT, make sure the ERA feeds into your billing system correctly. A common issue is ERA files not matching to the correct patient or claim because of formatting differences between payers. Test the integration thoroughly with your billing software before going live.