Exceptions in ERA Auto-Post

The Exceptions screen displays all claims from the ERA that are unable to auto-post, providing users the ability to either resolve the issue or manually mark them as resolved.

All exception claims are listed on the Posting Review screen with category-based filters for quick sorting of the list. Users can edit the exceptions to remove them from the exception list. The table below lists common exceptions and the actions that can be taken to remove them from the exception list.

 

Exception Type	Description	Suggested Action
Overposted Claims	Claims where the balance is negative	Correct the amounts and save the change. (For this scenario, do not use the Mark as Resolved option.)
Procedure Code Mismatch	Mismatched Procedure Code	Match the line from this screen and select Mark as Resolved
Invalid Line Status	Line status does not reflect the actual status of the claim	Correct the line status and select Mark as Resolved.
Reversal Not Processed	Claim with status code 22 not processed	The most likely scenario for this type of exception is due to an insufficient amount in the claim to process the reversal. Review the claim and balance the amount manually before proceeding.
Denial with Patient Responsibility	Here, the claim status code is 4, Paid amount is zero, and PR >= 0.	Move the line status to the next responsible party and save the change before proceeding.
Claim Not Found	A matching claim was not found	Manually try to match the claim with the claim # or else with the patient’s name and DOB.

 

ERA Exception Page Showing Reversal Not Processed

 

 

ERA Exception Page Showing Overposted Payments