Denials and A/R · 2026-04-02 · 4 min
Understanding ERA, EOB, and EFT
How electronic remittance, explanations of benefits, and electronic funds transfer fit together in payment posting.
Three different objects
An ERA is the electronic remittance advice, commonly the 835 transaction. It explains how a payment was allocated. An EOB is the human-readable explanation, on paper or in a portal, for the practice or the patient. EFT is the electronic funds transfer, the deposit itself. You can receive any one of them without the other two.
Posting needs the explanation and the deposit. An EFT without an ERA is money you cannot apply honestly. An ERA without a deposit is an explanation of cash that has not arrived, or that arrived under a different trace number.
How to read a line
A claim line can show a payment, a contractual adjustment, a patient responsibility amount, and a denial. Those are not synonyms. Contractual adjustment is the write-off a participation agreement requires. Patient responsibility becomes a statement only when it is final. A denial needs a next action.
Provider-level adjustments, often called PLBs on an 835, do not belong on a single patient's line. Forcing them onto a claim to make the batch balance creates a false balance for that patient.
A posting day that ties
List the deposit, the remit total, and any non-claim withhold before posting lines. Post at the line. Compare again at the end. A difference is a variance with an owner. It is not a plug spread across the oldest claims.
Zero-dollar remits are still remits. They often carry the denial. Ignoring them keeps A/R open and can trigger a statement.
When the payer will not send an 835
Some payers remain on portals or paper. That path has to be on a list, or it disappears. Enrollment for ERA is a clearinghouse task and it is separate from claim enrollment. Being able to send an 837 does not mean you will receive an 835.
Patient EOBs and practice EOBs can describe the same claim in different layouts. Staff answering the phone should use the practice's posted remit, not a patient's partial screenshot, as the source of the balance.
Close the day against the bank
Match each deposit to a remit batch before the posting day ends. Record the trace or check number, the deposit amount, the remit total, and any provider-level adjustment that explains a difference. A batch that does not match stays open. It is not forced to balance by moving dollars onto a patient.
Paper EOBs and portal downloads belong on the same list as 835 files, with a person named to enter them. Enrollment for electronic remits is separate from enrollment to send claims. Until that enrollment is effective, the manual path is the control, not a temporary exception nobody owns.