Electronic Remittance Advice
PAYER:
PAYEE:
CHECK/EFT NUMBER:
PAYMENT DATE:1
PAGE:1
DATE:
HEALTHCARE PAYER
ACME MEDICAL SERVICES
987654321
05/15/2024
05/15/2024
PROVIDER ID:1234567890
NPI:9876543210
TAX ID:12-3456789
CLAIM INFORMATION
ICN
PCN
PCN
MRN
MRN
SERVICE DATES
BILLED AMT
ALLOWED AMT
OTH INS AMT
ALLOWED AMT
COPAY AMT
PAID AMT
OUTPUT DED
MEMBER NAME: JANE SMITH
123456789012345
PCN:
MEMBER NO: J123456
0011223344
5566778899
04/01/2024
200.00
200.00
0.00
150.00
0.00
MEMBER NAME: JOHN DOE
PCN:
MEMBER NO: J789012
987654321098765
9988776655
04/01/2024
150.00
140.00
0.00
140.00
0.00
MRN: 1122334455
04/05/2024
180.00
140.00
0.00
140.00
0.00
ADJUSTMENT EOB:
0000
PROC CD MODIFIERS
SERVICE DATES
RENDERING PROVIDER
ALLW IINS
PA NUMBER
BILLED AMT
BENE PLAIT
COPAY AMT
PAID AMT
OUTPUT DED
BENE PLAN: 98765 26
SERVICE DATES 04/01/2024
ICN:
0.00
200.00
150.00
150.00
ALW UNTER
04/05/2024
BANE PE NO: 98765 26
RENDERING PROVIDER
MCD 11223344
0.00
180.00
0.00
140.00
MRN: 98700/39655
PA NUMBER
987654
0.00
180.00
0.00
140.00
ADDITIONIAL PAYMENT
30.00
PROC CD MODIFIERS
SERVICE DATES
RENDERING PROVIDER
ALLW IINS
PA NUMBER
BILLED AMT
BENE PLAIT
COPAY AMT
PAID AMT
OUTPUT DED
MEMBER NAME: ALICE JOHNSON
MEMBER NO: A123456
SERVICE DATES 04/01/2024
PCN:
220.00
220.00
150.00
60.00
PROC CD MODIFIERS
SERVICE DATES
RENDERING PROVIDER
ALLW IINS
PA NUMBER
BILLED AMT
BENE PLAIT
COPAY AMT
PAID AMT
OUTPUT DED
BENE PLAN: 98765 26
SERVICE DATES 04/01/2024
ICN:
220.00
180.00
0.00
180.00
BANE PE NO: 04/10/2024
RENDERING PROVIDER
MCD 11223344
0.00
160.00
160.00
160.00
MRN: 04/10/2024
PA NUMBER
987654
REFUND AMOUNT PAYMENT
10.00
Billed
$240.00
Allowed
$182.40
Paid
$145.92
Gap on this line
$94.08
× 1,200 claims / mo
CO
Contractual Obligation
We audit write-offs against your real fee schedules.
PR
Patient Responsibility
Collected, posted, and reconciled — not abandoned.
OA
Other Adjustments
Investigated, not accepted at face value.
PI
Payer-Initiated Reduction
The ones we fight — and usually win.
CARC 45
Charge exceeds fee schedule
CARC 16
Missing / invalid info
CARC 96
Non-covered
CARC 97
Bundled into another service
CARC 197
No prior authorization
CARC 29
Timely filing exceeded
N290
Root cause
Auth obtained
Corrected
Resubmitted
CL-220152 · CARC 197
PAID $182.40
99%
First-pass acceptance
38%
Denial reduction
28d
A/R days
6-fig
Annual recovery
EurekaSacramentoSF BayLos AngelesSan Diego
Inside the ERA · Chapter 0

Every dollar you're owedis written in here.Most practices never read it.

M-HIP turns remittance data into recovered revenue — for California providers.

Scroll to read your ERA the way we do
Chapter 1 · The Payment Line

The number that isn't there.

Billed becomes Allowed becomes Paid. Most practices only look at Paid. We interrogate the gap — every line, every claim, every month.

Chapter 2 · Adjustment Group Codes

CO. PR. OA. PI. Four acronyms that decide who pays.

Group codes route every adjustment. We audit contractual write-offs against your real fee schedules — a miskeyed contract silently bleeds 2–4% of revenue.

Chapter 3 · Reason Codes

The 30 codes that cost you the most.

CARC 45, 16, 96, 97, 197, 29 — we don't just resubmit. We trace each one to its root in your intake, coding, or auth workflow so it never recurs.

Chapter 4 · Remark Codes

The payer's footnotes. We read every one.

RARCs like N290, M51, MA130 spell out what to fix. They're the difference between guessing at a denial and answering it.

Chapter 5 · The Denial, Reversed

Root-cause → Auth → Resubmit → Paid.

A CARC 197 denial leaves the document, runs the M-HIP workflow, and lands back as $182.40 paid. This is the work, end to end.

Chapter 6 · The Pattern

One ERA is a document. A thousand are a map to your money.

99% first-pass acceptance · denials cut 38% · A/R days from 47 → 28 · six-figure annual recoveries for mid-sized CA practices.

Chapter 7 · California

Built for California providers.

Medi-Cal, CA-regional payers, state-specific timely-filing windows, and the payer mix from Eureka to San Diego. We work one state. Yours.

Who it's for

California practices, across the specialties that bill the most.

Family PracticeInternal MedicineBehavioral HealthUrgent CareCardiologyPediatricsOB/GYNOrthopedicsDermatologyEndocrinologyPain ManagementPhysical Therapyand more
Proof

Notes from the margin.

CO-45
"They found $61k in mis-keyed CO-45 write-offs in the first quarter. Not a guess — a line-by-line audit against our contracts."
Practice Manager, Sacramento family medicine
CARC 197
"Our 197 denials went from chronic to almost-zero in 90 days because they fixed the auth workflow upstream."
Billing Director, Orange County behavioral health group
A/R
"A/R days dropped from 51 to 29. Cash flow finally matched the schedule we were actually working."
Administrator, Bay Area urgent care
Free ERA Review

Send us one ERA. We'll show you what it's hiding.

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