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Insurance Payments & ERAs

When a payer pays, the money and the explanation arrive separately: the funds go to your bank, and the ERA (Electronic Remittance Advice) — the machine-readable version of an EOB — tells you which claims the payment covers and how each was adjudicated.

ERAs Arrive Automatically​

For payers you're enrolled with, ERAs flow into the Payments tab of the Insurance hub and post automatically — claim statuses update (usually to Paid or Deductible), payments are recorded against the right sessions, and client responsibility lands on client billing. There's no approval step to forget.

Your part is review: the "N new" badge counts payments nobody has acknowledged yet — work through them and set each row's Payment Status to Received once the money is confirmed in your bank (or Not Received to flag a problem).

Click into any payment (View Full Details) for the per-claim breakdown — billed, Client owes, insurance Amount, and Write-off per service line — plus Download EOB for the human-readable version. If the ERA referenced claims that couldn't be matched, an Unmatched Transactions section lists them: "Review and manually allocate as needed."

Recording a Payment Manually​

For payers that still send paper EOBs, before enrollment completes, or for claims you filed outside the platform (a payer portal, paper, or another clearinghouse):

  1. Go to Insurance in the left navigation and click Add insurance payment (top of the hub — also available from the Payments tab, and from the Insurance card on a client's profile)
  2. Select the payer first — the page then lists that payer's claims and insurance sessions that don't have a claim in the system yet
  3. Enter the Payment Number (check or EFT reference), method, and total
  4. Allocate the payment across the lines it covers — sessions without a claim can be paid directly, and a Filed externally claim is created automatically for the record
  5. Enter the Client owes and Write-off amounts from the EOB per line (the write-off auto-calculates) so balances stay accurate

Don't see the session you're trying to pay? A session only appears here when it has happened (not cancelled or a no-show), the client has that payer's coverage on file, and the session is insurance-billed rather than self-pay. The payer dropdown lists the payers your clients' coverages (and your existing claims) reference — if the payer is missing, add it to a client's insurance coverage first. And if saving fails with "Claim total is $0", the session has no service fee — set the fee on the appointment (or your service's default rate) and try again.

Unallocated Insurance Payments​

If a payment arrives that you can't fully match to claims yet (or a payer overpays), the unmatched remainder stays unallocated on the payment record — an orange summary card and a per-row amount make it visible: "This payment has unallocated funds — open View Full Details and use Edit to assign them to claims." Come back when the missing claim shows up and allocate the rest.

Adjustments​

The gap between your billed fee and the payer's allowed amount is a contractual adjustment (write-off) — recorded automatically from the ERA, not billed to anyone. Recording accurate contracted rates keeps expected-vs-actual comparisons honest so real underpayments stand out.