Supported Transactions
| Transaction | Status |
|---|---|
| Eligibility & benefits (270/271) | Not supported |
| Claim status (276/277) | Not supported |
| Professional claims (837P) | Supported |
| Institutional claims (837I) | Supported |
| Dental claims (837D) | Not supported |
| Electronic remittance (ERA 835) | Enrollment required |
| Electronic funds transfer (EFT) | Not supported |
| ERA + EFT combined | Not supported |
| Coordination of benefits (271) | Not supported |
| Attachments (275) | Not supported |
Enrollment requirements
- Electronic remittance (ERA 835): one click enrollment, typically takes days
Workflow Considerations
- Use 837I for institutional claims and 837P for professional claims, then verify the claim type before submission.
- Complete this payer's enrollment before expecting ERA delivery, and establish a process for posting remittance information.
- Verify coverage through another approved process because eligibility and benefits transactions are not supported.
- Track claim follow-up outside Hero EMR because electronic claim status transactions are unavailable.
- Reconcile payments through your existing payment process because EFT and combined ERA/EFT are unavailable.
Common questions
Can I submit institutional claims to this payer electronically?
Yes. Hero EMR supports institutional claim submission using the 837I transaction.
Can I submit professional claims to this payer electronically?
Yes. Professional claims can be submitted electronically using the 837P transaction.
How do I receive ERA from this payer?
ERA is supported through the 835 transaction after your practice completes this payer's enrollment. Enrollment paperwork must be completed before using ERA support.
Does Hero EMR support EFT or combined ERA and EFT for this payer?
No. EFT and combined ERA/EFT transactions are not available, although ERA alone is supported after enrollment.
Run this payer inside Hero EMR
Hero EMR submits claims, checks eligibility, and posts remittances automatically for the payers it connects to. The first physician is free.
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