View Remittance page presents ERA information in a more intuitive, searchable, and user-friendly format, providing greater visibility into insurance adjudication, simplifying remittance review workflows, and making it easier to review claim decisions, payment details, denial reasons, service-line adjudications, and provider-level adjustments without relying on external payer portals.
The View Remittance page serves as an enhanced alternative to the traditional ERA Preview, while preserving access to the original ERA documentation whenever needed.
In this article, you'll learn about:
- Understanding Remittance-Associated Views
- How to Access the View Remittance Page
- What's Included on the View Remittance Page
Understanding Remittance-Associated Views
Each view serves a different purpose:
- ERA Remittance - used to post and manage payments, adjustments, and claims associated with the remittance
- ERA Preview - displays remittance information using the legacy ERA preview layout previously available in RCM.
- View Remittance - provides an enhanced, searchable view of the remittance, making it easier to review claim adjudications, service-line details, denial reasons, and adjustments
Note: The ERA Preview option remains available from both the ERA Remittance page and the View Remittance page. Generated ERA Preview documents and original ERA (835) files are stored in the shared Attachments section and can be accessed from either view.
How to Access the View Remittance Page
The View Remittance page is automatically available for all ERA remittances received in RCM.
IMPORTANT: This functionality is available for electronic remittance advice (ERA) records only. EOB remittances entered manually from paper documentation are not supported.
To access the page:
- Navigate to the Remittance dashboard.
- Locate the desired remittance.
- Open the remittance record.
Once you open a remittance record, you will be taken to the ERA Remittance page. This is where you work with the remittance itself - matching claims, posting payments, distributing adjustments, and completing payment posting workflows.
- Click More Actions.
- Select Go to View Remittance.
The page opens in a separate browser tab, allowing you to review ERA details while continuing to work within the remittance record if needed.
What's Included on the View Remittance Page
The page is organized into five sections:
- Header
- Remittance Details
- Attachments
- Insurance Claims
- Provider-Level Adjustments (when applicable)
Header
The Header provides a high-level summary of the remittance, including:
- Remittance ID
- Received Date
- Document Type (EOB/ERA)
- Paid Amount
IMPORTANT: The Paid Amount reflects the value reported directly within the ERA file and is not calculated by RCM.
When provider-level adjustments are present, you can view additional details explaining whether those adjustments increased or decreased the remittance payment amount.
- Number of Claims (the number of claims indicated within the remittance)
- Number of Provider-Level Adjustments
The Header also provides quick access to:
- ERA Preview
- Go to ERA Remittance
Remittance Details
The Remittance Details section displays key information reported by the payer, including:
- Check/EFT Issue Date
- Payor Name
- Payor ID (ID that is used for electronic claim submission)
- Check/EFT Number
- Payment Method
This information is displayed exactly as received within the ERA file.
Attachments
The Attachments section provides centralized access to remittance-related documents, including:
- Original ERA (835) file
- Generated ERA Preview documents
- User-uploaded files
Files uploaded from either the ERA Remittance page or the View Remittance page automatically appear in both locations.
To add a file:
- Click Add Files.
- Select a file from your computer.
- Click Add.
Uploaded files can also be removed when no longer needed.
Insurance Claims
The Insurance Claims section displays all claims reported within the remittance and summarizes how each claim was adjudicated by the payer. From this view, you can review claim-level payment information, drill down into service-line details, investigate denials and adjustments, and quickly locate specific claims using built-in search and filtering tools.
The Insurance Claims section consists of:
- Claims Grid
- Filter Panel
- Claim Details View:
- Service Line Details
- Claim-Level Adjustments
Claims Grid
The main grid provides a claim-level summary of all claims included in the remittance.
The following columns are available:
- Patient - Patient Name and Member/Subscriber ID as reported in the ERA.
- CPT/HCPCS - Procedure code(s) reported on the claim.
Note: When a claim contains multiple service lines, multiple CPT/HCPCS codes may be displayed.
- Adjudication - Payor adjudication status determined by RCM.
- DOS - Date of Service.
Note: When a claim contains a service date range, the earliest Date of Service is displayed in the claim-level grid.
- CCN - Claim Control Number assigned by the payer and transmitted within the ERA.
- Financial Columns - The following columns display financial information received within the ERA:
- Billed - Amount billed to the payer
- Paid - Amount paid by the payer
- Pt. Resp. - Amount assigned to patient responsibility
- Ins. Adj. - Insurance adjustment amount
Note: These values represent claim-level totals reported within the remittance.
- Remark/Reason Codes - Displays codes received from the payer that provide additional context regarding payment decisions, denials, reductions, or other adjudication outcomes.
Note: Sorting is available for most columns except CPT/HCPCS and Remark/Reason Codes. Claims are sorted by Patient by default.
Note: Paging is available within the grid.
Understanding Adjudication Statuses
The Adjudication column displays the overall outcome of the claim.
Unlike most information shown on the page, adjudication status is determined by RCM based on the ERA data rather than being transmitted directly by the payer.
The following adjudication statuses are available:
| Adjudication | Logic |
|---|---|
| Paid | Insurance Paid and/or Patient Responsibility amount is greater than $0 |
| Denied | Insurance Paid and Patient Responsibility amounts are both $0 |
| Partially Paid | At least one service line is Paid and at least one service line is Denied (see Service Lines) |
| Adjusted | One or more claim amounts are negative, indicating a reversal or adjustment |
Advanced Filtering
The filter panel supports searching and filtering by:
- Patient (users can search by either Patient Name or Member/Subscriber/Insured's ID within the filter panel)
Note: Only patients reported within the selected remittance are available for filtering. In rare cases, a patient reported in the ERA may not exist as a patient record within RCM.
- CPT/HCPCS Code (users can search by Procedure Code or Procedure Description)
Note: Procedure descriptions are retrieved from RCM based on the CPT/HCPCS code reported within the ERA.
IMPORTANT: If a claim contains multiple procedure codes, selecting a single code in the filter will return all claims containing that code, even when additional procedure codes are present on the claim.
Note: Only procedure codes reported within the remittance are available for selection.
- Adjudication Status (users can also filter claims by Adjudication status using the filter panel)
- CCN/Claim Control Number (users can search and filter claims by CCN)
Note: Multiple filters can be combined to narrow down results and quickly locate specific claims within large remittances.
Claim Details
The claim-level grid provides a summary of the claim. To review payer adjudication in greater detail, users can expand an individual claim.
To do so, click the expansion arrow next to the Patient Name.
Two additional sections become available:
- Service Lines
- Claim-Level Adjustments
Note: The number displayed next to Service Lines reflects the number of service lines reported for the claim.
Service Lines
To review service-line details, expand the Service Lines section.
A secondary grid displays detailed adjudication information for each service line.
The following information is available:
- CPT/HCPCS Code
- Procedure Description
- Modifiers
- Adjudication
- Date of Service
- Units
- Allowed Amount
- Billed Amount
- Paid Amount
- Patient Responsibility Amount
- Insurance Adjustment Amount
- Remark/Reason Codes
Note: Procedure descriptions are retrieved from RCM based on the CPT/HCPCS code reported within the ERA.
Note: Allowed Amount is calculated as:
Allowed Amount = Paid Amount + Patient Responsibility Amount
Certain values within the service-line grid support additional descriptions. Descriptions are available for:
- Patient Responsibility Codes
- Insurance Adjustment Codes
- Remark/Reason Codes (when provided by the payer)
If you click on one of these values, the associated code description will be displayed.
This makes it easier to understand payer decisions and investigate denial or adjustment patterns directly within the remittance.
Note: When a claim displays adjudication Partially Paid, it means that at least one service line was adjudicated as Paid while another service line was adjudicated as Denied.
Note: When a claim or service line displays Adjusted, negative values are typically present within the financial fields. This indicates a reversal or adjustment of a previously issued payer decision. In many cases, adjusted claims are accompanied by another claim within the same remittance carrying an updated CCN that reflects the payer's revised adjudication decision.
Claim-Level Adjustments
The Claim-Level Adjustments section is available for every claim listed within the remittance.
A separate adjustment grid is displayed whenever claim-level adjustments are reported in the ERA.Unlike service-line adjustments, claim-level adjustments apply to the claim as a whole rather than to an individual service line.
Users can review:
- Adjustment Code
- Adjustment Description
- Adjustment Amount
Descriptions can be accessed directly from the adjustment code value.IMPORTANT: Search and filtering functionality applies to the main Insurance Claims grid only. Service-line records and claim-level adjustments cannot currently be searched independently.
Provider-Level Adjustments
When provider-level adjustments are reported within an ERA, they appear in a dedicated Provider-Level Adjustments section.This section displays:
- Provider Identifier
- Fiscal Period
- Adjustment Code
- Adjustment Description
- Adjustment Amount
Users can quickly review financial activity that impacts the overall remittance but is not associated with a specific claim.