TheraNest users with Billing Permissions AND permissions to submit claims to the clearinghouse will be able to perform the actions in this article.
Before You Begin
This workflow is only applicable to TheraNest users using the Apex clearinghouse.
Applying payments from the ERA does not automatically write off the balance of the invoice/claim.
- Click Billing on the primary navigation bar.
- In the sidebar menu click Claims > ERA Received tab. This tab contains all un-processed payment(s) from the payer.
Before you start processing you can check the date range and the customize your grid to include additional columns.
3. You can handle each payment one by one by clicking on the Actions button next to each payment. You can also process multiple payments at once by marking the box to the left of those ERA payments and choosing the buttons up top to Process Payments or to Mark as Processed.
One by One
To the right of every payment on the line you'll find the Actions button. In this dropdown you'll see the option to:
- Process Payment
- Mark as Processed
- Resolve Mismatch
This means you're taking the insurance payment and applying it to that invoice/claim on the ledger. When you choose this option the payment will automatically be applied to the invoice/claim. The payment will move to the Paid/Processed tab on the claims page.
Mark as Processed
No payments are being applied to the invoice but that payment line moves to the Paid/Processed tab. If you accidentally marked a payment as processed without applying it then you can reverse the movement. Go to the Paid/Processed tab > click Actions next to the payment > choose Mark As Not Processed. The payment will go back to the ERA Received tab for you to apply.
This means there is a payment but TheraNest was unable to find a claim for that payment due to the payer missing. You can then search for the client and select the payer.
4. Once the payment has been either processed or paid you then need to move the claim. Click the Accepted tab.
5. Next to the claims click Update Status. Choose Paid/Processed from the dropdown.