View electronic remittance (ERA) information, upload EDI files, upload EOB files, and more!
Table of Contents
Video
Granting Billiyo Access
Accessing Your Electronic Remittance Information
Review Remittance Information
Actions
Add/View Claim Notes
Mark Duplicate Claims
Upload an EDI File
Upload an EOB File
Manually Enter Payments
View Uploaded EDI Files
Download
Video
An electronic remittance (or ERA) is a HIPPA compliant electronic substitute for a paper explanation of payment or benefits.
Granting Billiyo Access
In order for Billiyo to be able to see your electronic remittance information, a request to grant Billiyo access needs to be submitted to your payers.
Billiyo cannot submit this request on your behalf. Payers may require you to fill out a form they provide for this.
Once permission has been granted and set up is complete, Billiyo is able to read and copy the remittance information to have it display within your Billiyo account.
Setup may not be immediate, some payers may take a month + to complete.
When should you expect to see remittance information load in Billiyo after setup is complete:
- The Wednesday after a billing week
Only remittance information for claims billed through Billiyo can be viewed in our system, claims billed via another system will not be visible.
Accessing Your Electronic Remittance Information
Within your Billiyo account, in the left menu navigate to:
Reports > Electronic Remittance
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Review Remittance Information
While you can certainly view all information, using the filters at the top of the screen and the search fields above the table can help to narrow down for particular claims.
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Within the table, the following information will be displayed:
| Client Name | The name of the client the claim was for appears here. |
| Payer | The name of the payer the claim was sent to appears here. |
| Claim Number | The number that was assigned to the claim appears here. |
| Claim Date | The date that the claim was sent appears here. |
| Check Date | The date the payment check was issued appears here. |
| Check Number | The check number from the payment check appears here. |
| Charges Amount | The total billed amount for the entire claim appears here. |
| Paid Amount |
The total amount that was paid by the payer appears here. |
| Adjustment | The difference between the charges and paid amounts appears here. |
| Patient Responsibility |
The total amount the patient needs to pay appears here.
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| Claim Status | The payment status (paid, partially paid or denied) appears here. |
| Service Date | The date range of the visits in the claim appears here. |
Clicking on the 
to the left of a table line, will reveal additional information about a claim on an individual line level.
| Service Date | The date of service from the claim line appears here. |
| Procedure Code | The procedure code that was worked appears here. |
| Mod1 | If the procedure code has a modifier, it appears here. |
| Charge Amount | The amount that was billed for the claim line appears here. |
| Units | The number of units billed for the claim line appears here. |
| Paid Amount | The amount that was paid by the payer appears here. |
| Adjustment Code | A reason from the payer appears here to provide more information about what they paid or did not pay from the claim line. |
| Adjustment Amount | The difference between the charge and paid amounts appears here. |
| Action buttons | Learn more about the action buttons here. |
Actions
There are several actions that can be taken within the electronic remittance page:
- Add/View Claim Notes
- Mark Duplicate Claims
- Upload an EDI File
- Upload an EOB File
- Manually Enter Payments
- View Uploaded EDI Files
- Download
Add/View Claim Notes
After expanding a claim line, by clicking the 
next to it, a Claim Notes button will appear.
Click on this button to view previous notes and add new ones.
| View Claim Notes | Add a Claim Note |
Mark Duplicate Claims
After expanding a claim line, by clicking the 
next to it, a Mark as Duplicate button will appear.
Click on this button, and then Yes on the pop-up that appears, to mark the claim as a duplicate.
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Upload an EDI File
EDI files are electronic documents used in the automated exchange of information. These files follow a specific, standardized format that has pre-set rules between a healthcare provider, Medicare and healthcare plans.
The EDI file comes directly from a payer and you may be able to access it within your payer portal. If you cannot, contact the payer to have them send it to you.
Within the electronic remittance page, locate the Upload EDI button that appears in the top-right corner of the screen.
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Upon clicking on the Upload EDI button, a pop-up will appear with fields to fill out.
| File Type |
Select the type of file you're adding, here are the options to select from:
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| Click or Drop Files to Upload |
Click into this field to select the file from your device, or drag and drop the file from your device onto this field.
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After filling out the above mentioned fields, click on the 
button.
Upload an EOB File
An EOB is an explanation of benefits that you receive from a payer that verifies claims have been processed.
The EOB file comes directly from a payer and you may be able to access it within your payer portal. If you cannot, contact the payer to have them send it to you.
Within the electronic remittance page, locate the Manual Payment button that appears in the top-right corner of the screen.
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Within the manual payment pop-up, click on either of the following to upload an EOB:
| The (Add EOB) text next to the EOB field |  |
| The Upload EOB button in the top-right corner of the pop-up |  |
On the pop-up that appears, fill out the following fields.
| Payor |
Select the name of the payer.
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| Provider NPI |
Enter your NPI number.
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| Provider Account Number |
Enter your provider account number, if you have one.
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| Check Number |
Enter the check number.
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| Check Date |
Select the date of the check.
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| Total Paid |
Enter the total paid amount on the EOB.
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| Click or Drop Files to Upload |
Click into this field to select the file from your device, or drag and drop the file from your device onto this field.
Accepted file type information:
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After completing the required fields, click on the button.
Manually Enter Payments
If you need to make adjustments to payments, use the manual payment option within the electronic remittance page to do so.
Within the electronic remittance page, locate the Manual Payment button that appears in the top-right corner of the screen.
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On the pop-up that appears, fill out the fields that display.
| EOB |
Select the EOB.
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| Claim Number |
Enter in the first part of the claim number, the part that starts with CLM.
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| Find Claim Details |
Click on the Find Claim Details button, located below the Claim Number field, to have the claim information populate in the table below.
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| Review and Edit Information |
The following can be edited:
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| Payer Claim Number |
Input the number that was assigned to the claim by the payer.
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| (Add Interest) |
If there was any interest paid, click on the (Add Interest) text next to the payer claim number field to add it.
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Upon filling out the fields on the pop-up, click on the 
button.
Once the above steps have been taken for a claim, an Edit Claim Payment button will appear when clicking on the 
to the left of the claim.
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Adjustments that are made will reflect in the claim detail report and denial analysis report pages.
View Uploaded EDI Files
After an EDI file has been uploaded into Billiyo, it can be viewed using the View Uploaded EDI button. This button is located in the top-right corner of the screen.
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Download
If you'd like to download information from this page, you can!
The information that is downloaded is based on what is filtered for and appears in the table.
The following file types can be downloaded:
| CSV |
Click on the CSV, located in the top-right corner of the screen to download a CSV file of the information.
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Click on the PDF, located in the top-right corner of the screen to download a CSV file of the information.
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If the file you are trying to download is larger, it may take up to 15 minutes for the generation to complete.
In cases like this, once the file is generated, it will be saved to the Download Documents page in your account and can be downloaded from here to your device.
Here's how to access the Download Documents page:
Reports > Download Documents
The report name will display as ERA Report.