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EDI 835: Electronic Remittance Advice (ERA)

The Electronic Remittance Advice (ERA), or 835, is the electronic transaction that provides claim payment information. These files are used by practices, facilities and billing companies to auto-post claim payments into their systems.

You can receive your 835 files through your clearinghouse, direct connection, or download them from the Electronic Payments & Statements app on Link.

Benefits

  • Eliminate manual keying; save time and effort
  • Reduce posting errors
  • Increase efficiency and save money

Getting Started

  • Contact your clearinghouse to request direct delivery of your UnitedHealthcare 835 files. Once we receive the request for 835s from your clearinghouse/EDI vendor, it takes about 30 days to set up delivery of the ERA/835.
  • Sign up for EPS to enjoy faster payment through direct deposit to your bank account and printable online EOBs on demand. Note: If you don’t enroll in EPS, you’ll receive unconsolidated 835 files (a file for each check you receive) and will continue to receive paper EOBs in the mail.

Tips

  • Registration and routing is completed at the Tax ID level. Split routing by Tax ID is not available.
  • Your payment schedule is not impacted by ERA/835 registration.
  • The ACS X12 005010X221A1 HIPAA Implementation guide and HIPAA Code Lists are on wpc-edi.com.
  • You can also refer to our Companion Guide page for more information.

Please review the following resources for an overview and tips on how to work with UnitedHealthcare's 835.

ACH, EFT: Automated Clearinghouse (ACH) is used interchangeably with Electronic Funds Transfer (EFT). ACH allows payment through the electronic transfer of funds into a bank account that the customer designates.

EFT 835: UnitedHealthcare's "EFT 835" is a HIPAA-format file ASC X12 combined 005010X221 and 005010X221A1 standard that may merge multiple individual 835s sent on the same day by Tax ID or NPI number. The EFT 835 ties to the ACH payment for that day's EPS deposit to your bank account. This facilitates receipt and tracking of payment for multiple claims.

EOB, PRA: Explanations of Benefits (EOBs) are sometimes called Provider Remittance Advice (PRA) and are typically in paper form.

EPRA: The Electronic Provider Remittance Advice is a document that resembles a Provider EOB/PRA that is created from the data provided in the EFT 835.

EPS: Electronic Payments and Statements (EPS) is a product that provides electronic delivery of payments and remittance advices (EOBs and/or ERAs) to physicians, hospitals and other health care professionals.

ERA: Electronic Remittance Advice (ERA) is also known as the HIPAA 835.

HIPAA 835: The 835 transaction is a standard transaction mandated by the Health Insurance Portability and Accountability Act (HIPAA) and is used to transfer payment and remittance information for adjudicated professional and institutional health care claims. The 835 returns payment information that is reported on paper EOB/PRAs to the care provider (or clearinghouse), in an electronic format. The ERA/835 uses claim adjustment reason codes mandated by HIPAA. The EOB/PRA displays UnitedHealthcare's proprietary denial/adjustment codes used in claim adjudication.