All About Remittances

All About Remittances

Overview

Long term you need to jump through the hoops to set up all the private insurance payers you bill so that electronic remittances are sent to your clearinghouse account. Once that happens CC should be able to automatically download and process the results so that claims are reconciled automatically. Please note, this process will not reconcile claims submitted prior to finishing this process. The general instructions to have remittances automatically download to Availity are located here. OKHCA remittances are downloaded and processed automatically. For other clearinghouses we will assist you as best as we can. 

Until this process set up for a payer claim items must be either be reconciled manually or you can continue reading for more information on download and import historical remittances manually.  

Downloading Remittances Manually

For Humana electronic ERA's importable to Chart Caddy, search Availity:
  1. Click tab for "Claims & Payments" > Claim Status
  2. In the Claim Status screen use the "Payer" menu to select Humana
  3. Enter all required field information for one client's claim (I searched all dates fro 4.1.24 through the present date instead of only one specific date and that worked best for me) > then "Submit"
  4. Click on a FINALIZED claim, will not work on Pending claims.
  5. Find the clickable "Remittance Viewer" > Download Text (X12) > click the checkbox for the remittance you want to download.
  6. Import the download to ChartCaddy per ChartCaddy's instructions.

For OCH 835/ERA login to Payspan (must have a registered account):

           1. After logged in, click "Your Payments", then...
           2. Click "View All" under " Confirmed 'Historical' Payments and Remits", then...
           3. Select checkboxes for all payments received in full, then...
           4. Select the action "5010" (at the top of the webpage)
           5. Click "Begin Download" (this will be the 835/ERA to use for importing into Chart Caddy

For Aetna Better Health:

      1. Login to echo payments. Must have a user account, if someone doesn't then they should go directly to echo's login website instead of using the instructions attached to their Aetna checks. The instructions attached to the Aetna checks will only give options for the All Payer EFT/ERA registration which will charge fees and as alternative it only gives the option to enroll in paper checks. Going directly to Echo's site enables you to view ERA's for free and without enrolling All Payer with fees associated per claim.

      2.  After logged in, click the "835" download link for all remittances you'd received full payment for. This will be the ERA to use for importing into Chart Caddy.

Importing Remitances

How to Import the remittances into ChartCaddy:
  1. Log in, and on the left hand side underneath the Settings menu there is an option for Import.
  2. Choose "ANSI 271/277/835 X12".
  3. Click Upload File and choose your document. Please do one at a time.
  4. Click Import.
If the Remittance upload process returns any number in the "Aliens" column, it simply means there were claim items on that remittance that could not be matched to the corresponding claim item in ChartCaddy. You may need to manually reconcile these when you are finished importing remittances.