What is ERA?
ERA stands for Electronic Remittance Advice. This is the electronic version of an EOB (explanation of benefits) that indicates if and how an insurance payer remitted on a submitted claim. Once an ERA has been uploaded into TheraNest, it can be viewed and processed it by following this set of instructions.
Payers require ERA enrollment through the clearinghouse in order to receive ERAs in your TheraNest account.
What is EDI?
EDI stands for Electronic Data Interchange. This is the name of the file that is transmitted from TheraNest to the clearinghouse, then on to the payer.
Some payers require EDI enrollment through the clearinghouse in order to submit electronic claims. If you are an Apex clearinghouse customer, you can click here to check the Apex Payer List for which payers require EDI enrollment. If you are with another clearinghouse, please reach out to your clearinghouse to inquire about which payers require EDI enrollment. You cannot submit claims to payers that require an EDI enrollment until the enrollment is approved by the payer.
For a more in depth overview of the Electronic Claim Submission cycle, click here to listen to our introductory episode of our insurance billing podcast, Billing Breakthroughs.