US Medical Billing

Remittance advice (ERA)

A remittance advice is the payer’s explanation to the provider of how a claim was paid or denied — what was allowed, paid, adjusted, and left to the patient. The electronic form is the ERA (X12 835).

Updated

A remittance advice is the payer-facing statement that tells a provider how a claim was processed: the allowed amount, what the plan paid, contractual adjustments, any denial or reduction with its reason codes, and the patient’s responsibility. Its electronic form is the Electronic Remittance Advice (ERA), the X12 835 transaction.

The reasons for any reduction or denial are carried as standardized Claim Adjustment Reason Codes (CARC) and Remittance Advice Remark Codes (RARC).

In practice

The remittance advice drives payment posting: it carries the payment, the contractual adjustments, and the reason codes that explain any shortfall — so posting it accurately is what keeps each patient balance correct and surfaces denials to be worked.

Commonly confused with

Sources

Ready to improve your revenue cycle?

Talk to our team about your practice — transparent process, clear reporting, no obligation.