EDI, EFT and ERA setup
Electronic transactions set up correctly, payer by payer
Electronic data interchange (EDI) is how claims, eligibility checks, acknowledgments and remittances move between your practice, a clearinghouse and payers using standard X12 transactions. EFT sends payments directly to your bank; ERA (the 835) delivers the payment detail electronically. Each payer often requires its own enrollment for each of these.
Does this sound familiar?
- Payments arrive as paper checks from payers that support EFT.
- ERAs are missing for some payers, so posting is manual.
- Claims are accepted by the clearinghouse but never reach the payer.
- A move to a new clearinghouse or PM system broke existing connections.
Scope of work
Exactly what this service covers — and what it doesn't — so responsibilities are clear before you sign anything.
Included
- Clearinghouse enrollment and payer connection setup
- Eligibility inquiry and response (270/271) configuration where supported
- Professional and institutional claim (837P/837I) routing
- Acknowledgment monitoring: 999 and 277CA
- Claim status inquiry (276/277) where supported
- ERA (835) enrollment and routing to your PM system
- EFT enrollment coordination, including CAQH EnrollHub where payers use it
Not included
- Bank account setup or changes — your authorized official makes those
- Custom software development or interface engineering
- Payers that do not support a given transaction electronically
How the work flows
- 01
Inventory
We list every payer and which transactions are live, missing or broken today.
- 02
Enroll
EDI, ERA and EFT enrollments are submitted for each payer that supports them.
- 03
Test
Test claims and remittances are traced end to end before relying on the connection.
- 04
Monitor
Acknowledgment reports are reviewed so silent failures are caught early.
What we measure
Measured against your own baseline. We don't quote benchmarks or other clients' results.
- Electronic remittance coverage
- Share of payments received with an ERA rather than a paper EOB.
- EFT coverage
- Share of payment volume received by EFT.
- Acknowledgment exceptions
- Claims with no 999 or 277CA acknowledgment after submission.
What we need from your practice
- Clearinghouse account or agreement to set one up
- Practice tax ID, NPIs and authorized official for enrollment signatures
- Bank letter or voided check, delivered securely by your team for EFT forms
- Patient information is exchanged only through secure access you control — never through forms or email on this website.
EDI, EFT and ERA setup: common questions
Which clearinghouses do you work with?
We confirm compatibility with your existing clearinghouse during the assessment. If you do not have one, we help you evaluate options; we do not receive referral fees from clearinghouses.
Why do we still get paper checks?
Usually because EFT enrollment was never completed for that payer, or it was tied to an old bank account or tax ID. The inventory step shows exactly which payers are affected.
Related services
- Credentialing, payer enrollment and contractingCAQH, NPPES, PECOS, Medicaid and commercial payer enrollment, revalidation and roster updates.
- Payment posting and reconciliationERA and EOB posting, adjustments, refunds and deposit reconciliation.
- End-to-end medical billingCharge entry through payment — claims built, scrubbed, submitted and followed until resolved.
Primary sources
Content last reviewed . Payer rules change; this page is general information, not legal or coding advice for a specific claim.
Talk to us about edi, eft and era setup
Tell us where payments are getting stuck. In 20 to 30 minutes we'll show you what we'd check first, and tell you plainly if we can help.
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