Electronic remittance advice (ERA) is the electronic explanation a health plan sends a provider when it pays or adjusts claims. Under HIPAA it is the X12 835 Health Care Claim Payment/Advice, version 5010. One ERA usually covers several claims and reports, for each claim and line, the payment and the reason and amount of each adjustment.
Why it matters when licensing company data
CMS notes that payments and adjustments can be posted automatically from an ERA, which removes manual posting from paper remittances. The ERA carries a reassociation trace number (TRN) that matches the electronic funds transfer, so the payment can be reconciled to the bank deposit. Each adjustment pairs a group code, such as CO for a contractual obligation or PR for patient responsibility, with a claim adjustment reason code, and remark codes can add detail.
The ERA goes to the provider. The patient receives an explanation of benefits, which CMS describes as a statement of the total charges for a visit that is not a bill. The claim itself travels the other way as an X12 837.
See how to read an 835 file and claims and remittance records.
Example
A billing company receives one ERA from a commercial payer covering forty claims and a single EFT. Its posting software matches the TRN to the deposit, posts each payment, and sends every line with a denial code to the work queue. At month end, the company reconciles ERAs to deposits and lists any payer that sent money without a remittance.
Source
CMS: Electronic Remit Advice (ERA) and Standard Paper Remit (SPR). Definition reviewed November 9, 2026 by Origin Data Partners.