What is ERA?
Also called: electronic remittance advice · 835 file
The ERA is where denial intelligence actually lives. Every adjustment carries a claim adjustment reason code, and reading those codes in aggregate rather than claim by claim is what turns denial management from firefighting into prevention.
A practice that posts ERAs automatically but never analyzes the CARC distribution is discarding the most valuable dataset it owns.
Where Vizora handles this
Primary sources
Where "ERA" is defined by the bodies that set the rules, rather than by us.
- CMS-1500 claim form standards (opens in a new tab)
National Uniform Claim Committee — Maintainer of the CMS-1500 professional claim form and its data element definitions, plus the provider taxonomy code set.
- Medicare Claims Processing Manual (opens in a new tab)
Centers for Medicare & Medicaid Services — The operative manual for how Medicare claims must be coded, submitted, adjusted and appealed. When a payer policy and a vendor's advice disagree, this settles it.
- CAQH Index: cost of administrative transactions (opens in a new tab)
CAQH — Per-transaction cost of eligibility checks, claim status inquiries and prior authorization, manual versus electronic. The best public evidence for automating front-end work.
Last reviewed August 20, 2026
Related terms
CARC
A claim adjustment reason code explains why a payer adjusted or denied a payment. Maintained by X12, each CARC carries a group code — CO for contractual obligation, PR for patient responsibility, OA for other adjustment — which determines whether the balance may be billed to the patient.
RARC
A remittance advice remark code supplements a CARC with the specific reason behind an adjustment. Where a CARC says information is missing, the RARC says which information. Reading the RARC is usually what determines whether a denial is correctable, appealable, or genuinely final.
Payment Posting
Payment posting is the recording of payer and patient payments against the correct claims and service lines, including contractual adjustments, write-offs and patient responsibility. Done well it reconciles to the bank deposit; done poorly it corrupts every AR and denial report downstream.
More in Claims and submission
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