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Electronic Remit Advice (ERA) and Standard Paper Remit (SPR) After Medicare processes a claim, either an ERA or an SPR is sent the provider with final claim adjudication and payment information. One ERA or SPR is generally sent to a provider for all the claims being paid as the waiting period for payment has been completed, or denied on the same day. Itemized information is reported within that ERA or SPR for each claim to enable the provider to associate the adjudication decisions with those claims as submitted by the provider. The ERA or SPR reports the reason for each adjustment that may have been made to a claim, the value of each adjustment, and any provider level adjustments, such as an increase in payment for interest due as result of late payment of a clean claim by Medicare or a deduction from payment as result of a prior overpayment. One check or electronic funds transfer (EFT) is issued when payment is due, representing all benefits due from Medicare for the claims itemized in that ERA or SPR. Medicare recommends that providers accept ERA transmissions in lieu of mailed SPRs, and that they accept EFT payments rather than paper checks. The amount payable for each claim as well as each adjustment applied to a claim can be automatically posted from an ERA, eliminating the time and cost for staff to post this information manually from an SPR. ERAs generally contain more detailed information that there is not space to report on an SPR. SPRs do not contain any information that is not available on an ERA, and where the same fields are reported on an SPR as in an ERA, the information in those fields is identical. Please see the separate page in this EDI section for further information on the benefits of acceptance of EFT for Medicare claim payments. All ERAs sent by Medicare contractors are currently in the X12 835 version 4010A1 format adopted as the national HIPAA ERA standard. There is a link below to this version of the ERA. Medicare provides free software to read the ERA and print an equivalent of an SPR using the software. Institutional and professional providers can get PC Print and Medicare Easy Print (MREP) respectively from their contractors. These software products enable providers to view and print remittance advices when they need them eliminating the need to request or await mail delivery of SPRs. The MREP software also enables providers to view, print, and export special reports. See the Medicare Claims Processing Manual, (Pub.100-04), Chapters 22 and 24 for further remittance advice information.
Page Last Modified: 12/08/2008 12:55:45 PM
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