Understanding how long ERA and claims take to process helps you keep your billing workflow predictable and efficient. Although processing times can vary, knowing what to expect will help you stay organized and avoid unnecessary delays.
What is an ERA?
An ERA in insurance stands for Electronic Remittance Advice, a digital notice sent by an insurance company that explains how a healthcare claim was processed and paid. It details what was billed, what the insurer paid, adjustments, denials, and the amount owed by the patient. An ERA helps providers post payments accurately and reconcile claims faster than paper explanations.
What is Carepatron’s clearinghouse?
Claim.MD is the clearinghouse that connects Carepatron to insurance payers. It delivers your claims to the correct payer, checks for basic formatting errors, and returns ERAs once the payer has completed its review. This allows you to track claim statuses and payment information directly within Carepatron.
How long do ERAs take after enrollment?
Each payer must approve your ERA enrollment. This enrollment period can take anywhere from a few days to several weeks, or up to 30 days, depending on the payer.
Once approved, ERAs generally begin flowing within a few business days. However, it is completely normal for some payers to take longer.
How long do claims take to process?
Claim processing times vary by payer. Many payers process claims within a few business days, while others may take several weeks.
Even if your ERA enrollments are still processing or pending, we recommend filing at least one claim for the payer as soon as possible. Filing early ensures your claims enter the payer’s queue right away, helping you avoid reimbursement delays.
Must read:
Getting started with Billing
Setting Up Insurance Billing in the Workspace
Setting Up a Client’s Insurance Details
Tracking Unpaid Insurance and Adding Payments
Tracking Electronic Claim Submissions.
Creating a US Professional CMS 1500 Claim
FAQs
Why are my ERAs delayed?
This usually happens when your ERA enrollment is still pending with the payer. Check your enrollment status and confirm that all required forms have been approved.Also, when coming from another system that also uses Claim.MD, the ERA enrollment process is actually blocked. Claim.MD requires that ERA be stopped in the other system first, before they can process ERA enrollments with Carepatron.
Why are my claims taking longer than expected?
Some payers take several weeks to process claims. Delays can also occur if the claim is missing codes, contains outdated client insurance information, or requires correction after a rejection.How can I check for claim issues?
Look for rejection messages or clearinghouse alerts in your claims list. These will indicate what needs to be fixed before resubmitting.Can a payer delay claims if they do not accept electronic submissions for the plan?
Yes. If the specific plan does not support electronic claims, processing may take longer or require a different submission method.Can I ask the Carepatron team about the status of my ERA enrollment while it is being processed?
Carepatron doesn't have visibility into the processing status on the payer's side or within Claim MD. The status in Carepatron will automatically update once the ERA is fully processed and received. However, you may contact the Carepatron support team so we can raise support cases with Claim.MD on your behalf.My claim shows as paid, but I did not receive any payment. What should I do?
This usually means the payer marked the claim as paid, but the payment itself was issued outside of Carepatron. It is best to contact the payer directly to confirm how the funds were sent.How can I speed up ERA enrollment and claim processing?
Submit clean claims, keep client insurance details up to date, use accurate CPT and DX codes, file claims promptly, monitor enrollments, and resolve rejections quickly so you can resubmit without delays.Do I have to complete ERA enrollments for every payer I work with?
Yes, ERA enrollment is a payer-specific requirement. You must complete a separate ERA enrollment for each payer you work with to instruct them to send payment and claim details (ERAs) to Carepatron.What happens if I don't have an ERA enrollment?
Without ERA enrollments, Carepatron will not receive any payment details. This means:Claim status stalls: Claim statuses may not automatically update to "Paid" or "Denied" when claims are processed
No automated payments: Payments and adjustments will not be added to the client's billing account.
You must manually track the status and manually enter payment details, which can be slow and error-prone.
Our team will be available to answer any further questions you may have. Just reply via messenger through the Help channel in your workspace.