Reviewing ERAs and remittances on claims
Review posted payer remittances from a claim, understand how the payer split the balance, export ERAs as CSV when needed, and create a secondary draft when another policy should be billed.
Use Claims to review remittances across the practice. For one patient’s claims, use the patient chart and its Claims area. Open a claim to see its payment summary, service lines, messages, remittances, payments and history. On archived patients, the claims page stays readable, but posting and secondary-billing actions are disabled.
How do I review a remittance on a claim?
In the left sidebar, click Claims. Then select the claim you want to review to confirm how the payer adjudicated it and what work remains. The claim details panel shows the payer’s amounts at both the claim and service-line level, and the remittance area opens a Remittance advice dialog with ERAs (1) and Payments (2) tabs, plus an Export (3) button for CSV exports based on the current search and filter state. Use the Payments tab to open payment rows, reconcile them, and filter the list by payment date. If ERAs or payments fail to load, the browser shows an error state with a retry action. In the payment detail view, you can see the payment reconciliation state, overdue status, and links to related ERAs.
- In the left sidebar, click Claims.
- Select the claim you want to review.
- In Payment summary, compare Billed, Allowed, Insurance paid, Writeoff, Denied and Patient owes.
- Open the remittance area to review the Remittance advice dialog.
- Use ERAs or Payments to switch between remittance records and payment rows.
- Use Export to download the current ERAs as CSV.
- Review each service line for Allowed, Paid, Denied and Writeoff and Adjustments.
- Check Messages for payer or clearinghouse messages tied to the claim.
- Open History to confirm events such as ERA received, Payment received or Card charge scheduled.
After the remittance is posted, the claim shows what insurance paid, what was written off, what was denied, and what may still be owed by the patient or another payer.
How do I read Payment summary?
On the same page, use Payment summary to understand the claim balance before you invoice the patient or bill another payer.
| Field | What it means |
|---|---|
| Billed | The total charge on the claim. |
| Allowed | The amount the payer allowed, when the payer returns it. |
| Writeoff | The contractual adjustment shown as a writeoff. |
| Denied | The amount still open with the payer because it was denied. |
| Insurance paid | The amount paid by insurance. |
| Collected at visit | A copay collected before adjudication, shown as an estimate. |
| Patient owes | The patient responsibility after adjudication, unless a secondary payer is still pending. |
If a secondary claim is pending, the primary payer’s patient responsibility is not the patient’s final balance. The second payer still needs to rule.
How do I review line-level adjustments?
On the same page, use the service lines when the total does not explain what happened. Each line can show its own payment, denial and adjustment information. Use Denied (1) to spot the refused charge, Writeoff (2) for the contractual reduction, and Adjustments (3) for the group-code pair, label and amount.
- Find the service line you want to review.
- Compare the line charge with Allowed, Paid, Denied and Writeoff.
- Review Adjustments for the group-code pair, label and amount.
Denied line amounts are shown separately from writeoffs, so you can tell the difference between a contractual reduction and a refused charge. Manual remittances are shown as Entered by hand, their remittance details include a Reference field, their 835 download button is hidden, and Replaced remittances appear separately from active ones.
How do I create a secondary claim from a remaining balance?
On the same page, open an adjudicated claim. When the claim opens Bill this balance to the secondary payer?, Ona creates a new draft claim for the other payer instead of resubmitting the primary claim. On an archived patient’s claims page, this action is disabled.
- Review the patient, primary payer and balance in Bill this balance to the secondary payer?.
- Select Create secondary claim.
- Open the new draft and set the filing code before submitting it.
Ona creates a draft secondary claim, closes the dialog, opens the new draft, and shows Secondary claim created. The original claim is closed, and the patient is not invoiced until the second payer rules.
If the patient does not have a second insurance policy on file, the dialog shows No second insurance on file. Add the secondary coverage to the patient record, then bill the balance again. If the balance was already billed to another payer, the dialog shows Secondary already filed and may offer View secondary claim. Replaced remittances also appear separately from active ones in the remittance list and the Payments tab.
How do I use claim history while reviewing remittances?
On the same page, use History (1) to open the timeline, select a claim update event (2) to read what happened, and use View snapshot (3) when you need to compare the claim version linked to that event. History entries include claim edits, submissions, payer status updates, ERAs, payment events, visit copay invoice handling and copay returns.
- Look for events such as Submitted to payer, ERA received, Payment received, Card charge scheduled, Denied by payer, Secondary claim filed, Copay set, Copay collected, Held copay applied, Invoice ready to send or Copay returned to account.
- Select View snapshot on an event when you need to compare the claim version linked to that event.
History gives you a timeline for remittance review and follow-up, without changing the claim.
What can't I do here?
Remittance review and follow-up are limited in these ways:
- Owners, admins and staff use the operational claims workspace. Members who are only clinicians do not use the full claims queue.
- If insurance billing is turned off, Claims is not available and patient claim tabs redirect back to the patient record.
- On an archived patient’s claims page, posting and secondary-billing actions are disabled.
- You cannot create a secondary claim when the claim is not adjudicated, when it is already a secondary, when there is no secondary policy on file, or when the secondary was already filed.
- A pending secondary claim means the patient balance is not final yet.
- Manual remittance date fields validate inline, and incomplete or invalid paid date and claim received date entries block saving.
- Pre-submission validation errors block claim submission until they are fixed.
- The 835 download action is hidden for manual remittances, which show Entered by hand instead.
- Export downloads ERAs as CSV using the current search and filter state.
- The remittance dialog also includes a Payments tab, where you review payment rows and reconcile them, and if the ERAs or payments fail to load the browser shows an error state with a retry action, but the claim still needs a remittance to post before those details matter.
Common questions
Where do I see what insurance paid?
On the claim page, review Payment summary and the Remittance advice dialog. Insurance paid shows the paid amount, and each service line can also show Paid.
Where do I see what the patient owes?
On the claim page, review Patient owes in Payment summary. If a secondary payer is pending, the primary payer’s patient responsibility is not treated as the final patient balance.
How do I know whether a charge was denied or written off?
On the claim page, use Payment summary and the service lines. Denied is shown separately from Writeoff, and denied line amounts are labeled as denied rather than contractual writeoffs.
How do I export ERAs as CSV?
Open the Remittance advice dialog from a claim and select Export to download the ERAs currently shown by the search and filter state.
What happens after I create a secondary claim?
Ona creates a new draft secondary claim and opens it. Set the filing code, review the draft, then submit it when it is ready.
Where can I see the remittance timeline?
On the claim page, select History. Events such as ERA received, Payment received, Card charge scheduled and payer decisions appear in the timeline.
What does Entered by hand mean?
It means the remittance was entered manually instead of coming in as an ERA. In the claim detail view, manual remittances show Entered by hand and include a Reference field.
What does Replaced mean on a remittance?
A replaced remittance is not the active one. It stays listed separately so you can tell the replacement from the remittance currently in force.
How do I review payments in the remittance dialog?
Open Remittance advice from a claim in Claims, then switch to Payments. Open a payment row to review its reconciliation state, overdue status, and links to related ERAs. If the payments browser fails to load, use the retry action in the error state and try again.
How do I filter remittances by payment date?
Open the Remittance advice dialog from a claim in Claims. Use the payment-date filter in the Payments tab to narrow the list before you open a row.
What do the copay events in History mean?
They show what happened when the visit copay moved through billing, such as when it was set, collected, applied to the invoice, or returned to the account.
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