Understanding Healthcare Payment, Remittance Advice and EMT (Electronic Funds Transfer)

Remittance advice transaction and health care payment could be either of the two:

  • Explaining remittance advice or the benefits from a certain health plan to the healthcare provider
  • Explaining payment along with all the details about payment processing and transfer of funds, starting right from a particular health plan to the healthcare provider’s financial institute.

What Is an Electronic Funds Transfer (EFT)?

EFT also known as electronic funds transfer refers to the electronic message used by health plans, in order to instruct any institution in order to transfer their funds electronically, to the health provider’s account which pays for the health care services. It includes the following information: 

  • Name and identity of the payee and the payer
  • Date of the payment
  • Amount being paid
  • Bank account details of the payee and the payer
  • Routing numbers

What Is An ERA?

ERA also referred to as electronic remittance advice refers to the explanation that is given to a health care provider from a health plan about the payment of claims. An ERA describes the health plan and how it has adjusted the claim charges on the following factors: 

  • Secondary payers
  • Expected co-insurance and copays
  • Contract agreements
  • Benefit coverage