ERA Integration Setup

The ERA Integration Setup function contains the information required for posting electronic remits. This information only needs to be entered one time for each electronic form number.

Upon accessing this function, first select the Insurance Form for the carrier you want to set up.



Click the Upload Files Action Column button to manually upload an ERA file when needed (for example, when a remit was not automatically imported through the Import Path).

After selecting the Insurance Form, the ERA Integration Setup screen displays. From this screen, identify the payment code and adjustment code to be used in posting, the Insurance Carrier Code to be used to post to the patient's insurance ledgers and statistical files, and the Deductible Not Met reason. Use the Exceptions section to control how the system handles specific ERA payment exceptions during posting.



Data Field Information
Prompt Response Req Len
Payment Code The Payment Code indicates the code you want to use when posting electronic remits. Type the code you want or click the magnifying glass icon to display the available codes. 5
Adjustment Code The Adjustment Code indicates the code you want to use when posting electronic remits. Type the code you want or click the magnifying glass icon to display the available codes. 5
Carrier Code The Carrier Code needs to be the carrier code you have set up in your Insurance Carrier Code Table. Type the code you want or click the magnifying glass icon to display the available codes.   5
Deductible Not Met Reason If the deductible amount matches the billed amount, the denial is posted to the patient's account and displays in the Insurance Ledger. Enter the reason for denial if the deductible has not been met.   40
Import Path Specifies the folder where CGM webPRACTICE will look for remittance files. This must be a valid path accessible from the CGM webPRACTICE server, and there must be a backslash (\) at the end of the path name. 50
Exceptions
Allowed Amount Doesn't Match Suppress: If you want to suppress this exception and allow payments/adjustments to be posted, select this check box. When the Suppress check box is selected, this exception will not print on the Electronic Remittance Exception Report.   1
Allowed Amt Doesn't = Calculated Pmt/Adj Suppress: If you want to suppress this exception and allow payments/adjustments to be posted, select this check box. When you select this check box, the Post check box will be automatically selected and this exception will not print on the Electronic Remittance Exception Report.

Post: If you want to always allow payments to be posted that have this exception, select this check box. If you want these exceptions to print on the Electronic Remittance Exception Report, do not select the Suppress check box for this exception.		   1