ERA Billing Options Tab

Follow the steps below to view and edit the billing options for ERAs associated with this payer.

1. Select Customer Setup > Payers.

2. Use the Show All button to view all payers. Or use the Search field to further drill down your search.

3. Select the Payer.

4. Click the Billing Options tab from the side panel. 

5. Make your selections by referencing the Billing Option Descriptions below. 

6. Process PR-45 (patient responsibility amount in excess of fee schedule/maximum allowable) as an Adjustment when an ERA is posted, rather than as Unpaid?

   1. If set to Yes, the system will adjust the PR~45 (patient responsibility adjustment due to a contractual overage) when an ERA is posted, rather than setting it as Unpaid. 

7. Process PR-242 (services not provided by network/primary care providers) as an Adjustment when an ERA is posted, rather than as Unpaid?

   If set to Yes, the system will adjust the PR~242 (services not provided by network/primary care providers) when an ERA is posted, rather than setting it as Unpaid. 

8. Click Save.