Healthcare Data GlossaryTech
ERA: Definition and Healthcare Context
Full name: Electronic Remittance Advice
An Electronic Remittance Advice (ERA) is a HIPAA-standard electronic document (ASC X12 835 transaction) that a health care payer sends to a provider explaining payment decisions on submitted claims. ERAs specify which services were paid, denied, or adjusted and include standardized reason codes. Under HIPAA, payers must transmit ERAs to providers who request them electronically. ERA data is the primary mechanism for providers to reconcile Medicare and commercial insurance payments in accounts receivable management systems.
Last updated: 2026-06-17Reviewed by: Dr. Jennifer Montecillo, MD — Gullas College of Medicine, 2019. Non-practicing medical reviewer.
How it’s used
- CMS PECOS Medicare Provider Enrollment: Medicare ERA transactions are routed to the provider's enrolled PTAN/NPI, making PECOS enrollment the prerequisite for receiving electronic Medicare remittance data.
Frequently asked questions
- What is an ERA?
- An ERA (Electronic Remittance Advice) is an X12 835 transaction that a payer sends electronically to a provider explaining how a claim was processed and paid.
- What is an X12 835?
- X12 835 is the HIPAA-standard EDI transaction set for health care payment and remittance advice — the technical format underlying ERA.
- How is ERA different from EOB?
- An ERA is a provider-facing payment reconciliation document in X12 835 format. An EOB is a member-facing informational document in human-readable format.