Sessions Health ERAs: Stop Hand-Entering EOBs
By George Ruan • September 23, 2026
Last reviewed: October 8, 2026.
If you are typing every insurance EOB into Sessions Health, the usual cause is missing ERA enrollments. Sessions Health applies an electronic remittance (ERA, the 835 file) to the claim and marks it paid on its own, but only for payers you have enrolled through its clearinghouse, one payer at a time. Manual entry is for the payers that still send paper or are mid-enrollment.
Sections
Enroll each payer for ERAs
Sessions Health submits claims and receives ERAs through its clearinghouse, Claim.MD. Its Insurance FAQs say you do not need your own Claim.MD account, and that if you belong to one you will need to be removed from it. Per Insurance: Enrollments, the steps are:
Add the correct Payer ID to the payer under Billing Settings > Insurance > Payers. You can only enroll payers that have one.
Click Enroll next to the payer, then Go to Paperwork, and follow that payer’s instructions. Each payer’s paperwork differs.
When the payer tells you the enrollment is approved, mark it approved in your Payers list. Sessions Health warns not to do this before the payer confirms, or claims may reject and ERAs may not arrive.
Many payers never send an approval. The FAQs say the first sign is often ERAs starting to arrive after you submit claims, and that the payer’s EDI department can tell you the status. If an enrollment is denied, fix the reason the payer gives and use the red Denied button next to Remittance to resubmit.
Watch where the ERAs go now. Sessions Health notes in Claims: Remittance that most payers send ERAs to one place only. Enrolling there moves them away from your old EHR or biller, and enrolling somewhere else later moves them away from Sessions Health. We check for this before Bomi files any ERA enrollment for a practice, because a well-meant enrollment through another clearinghouse can leave the EHR with no remittances at all. If claims for older visits are still being paid in the old system, see switching EHRs with unpaid claims.
What happens when an ERA arrives
For an enrolled payer, Sessions Health applies the payment and adjustments from the ERA, marks the claim paid, and shows the breakdown on the claim’s Remittance tab. A claim shows Processed once remittance has come in for every service on it, per Claims: Status. If a payer later reverses an ERA, Sessions Health keeps the original marked Reversed and saves the new one separately.
Your job shifts from typing to checking: review what the client now owes, read any denial message (Insurance > Payments, then View on the ERA), and fix remittances that are wrong from the claim’s Remittance tab.
Paper EOBs and payers without ERAs
Sessions Health lists four reasons to enter remittance by hand: the remittance came before the ERA was processed, the payer does not support ERAs, you are not enrolled, or enrollment is in progress. Per Claims: Remittance:
One claim: open the claim’s Remittance tab, click Add Remittance, and copy the EOB amounts into each service row. The calculator icon fills in the write-off.
One check for many claims: go to Insurance > Payments and click +Add. Pick the payer and the service date range, check each client and service on the EOB, enter Client Owes and Insurance Paid, and calculate the write-off. Then enter the Payment Date and Payment Number. If it will not save, a box is empty; enter $0 where nothing applies.
Money taken back: when a payer recoups by letter, phone, or portal and no ERA shows it, record a manual clawback as described in How to Record an Insurance Clawback or Reversal. The reversal is linked to the original payment, so both stay on record.
Two habits keep manual posting clean. First, post only from an EOB or ERA. A portal status of “paid” does not tell you the allowed amount, the adjustments, or what the client owes. A check that arrives with no EOB stays unposted until the payer sends the explanation. Second, watch for doubles. Some payers send both paper and electronic remittance. In one of our Sessions Health accounts, a Medicaid paper EOB arrived before the ERA or the money did, and the ERA came through a few days later. Before entering a paper EOB, check the claim’s Remittance tab, and wait briefly if the payer normally sends ERAs.
Secondary insurance payments
Secondary claims in Sessions Health start from the primary’s remittance. Per Pending Submissions Dashboard, a secondary claim appears there only after a primary remittance is applied, the client has an active secondary policy for that date of service, a balance remains, and no secondary claim has gone out yet. Missing policy start or end dates can keep a secondary off the dashboard or make old claims appear there.
Primary paid by ERA: Sessions Health builds the secondary with the primary’s adjustments for you. Review it and click Submit.
Primary entered by hand: you will see “Incomplete Patient Responsibility (PR) adjustments.” Add the reason codes under Details > Adjustments so they add up to the patient responsibility, such as 1 for deductible, 2 for coinsurance, or 3 for copay, as Claims: Secondary Claims explains. For a primary denial, enter $0 Insurance Paid and the full balance under Client Owes.
Crossed over automatically: if Medicare forwarded the claim to the secondary, it shows under the Submitted tab and you do not submit it again.
When the secondary pays, enter or review that payment on the secondary claim’s Remittance tab and write off what the EOB shows as the contractual adjustment. In one case we handled, Medicaid paid a small secondary amount; we posted it, wrote the rest off as Medicaid’s adjustment, and the client owed nothing for that visit. If a secondary had to be filed outside Sessions Health, mark the claim Submitted Externally and add its remittance to that claim by hand when the EOB or ERA arrives. For the payer-side order of operations, see how to bill primary and secondary claims.
Match deposits to ERAs
Insurance money never passes through Sessions Health. The payer pays you directly by check, virtual card, or direct deposit (EFT). Sessions Health does not handle EFT forms; per Insurance: Enrollments, set up EFT in each payer’s portal or by calling the payer. Changing EFT should not affect your ERA enrollment unless the EFT form also changes claims or remittance routing.
To tie a deposit to its ERA, use the trace number. CMS’s EFT and ERA reassociation guide explains that health plans put a reassociation trace number (TRN) in the EFT and the same number in the matching ERA. Your bank does not always show it. Ask your bank to include it in deposit notices. The same guide says plans should release the ERA within three business days before or after the EFT date, which matches Sessions Health’s note that an ERA can lag a deposit by up to three business days, or the other way around.
For each insurance deposit, find the trace number, amount, and date in your bank detail.
Find the ERA or EOB with the same number and total. On manual entries, put the check or trace number in Payment Number so you can search for it later.
Use the Payments report in Insights, filtered to insurance payments and Posted Date, to confirm what was applied for the period. It downloads as a CSV.
Deposit but no ERA after three business days: confirm with the payer that your ERA enrollment is active, then send Sessions Health support the payment amount, payment date, and check or payment number, per its enrollment troubleshooting. Missing ERAs often come from a second account with the same NPI and Tax ID, or ERAs going to another clearinghouse.
The reverse case, an ERA with no deposit, is covered in ERA received but no bank deposit. If payers are sending virtual cards with fees, see switching from virtual cards to EFT.
Moving to Sessions Health
Per Importing Your Data into Sessions Health, you export from your old EHR, upload one ZIP file under Forms and Documents > Internal Files (one ZIP per practitioner in a group, up to 1GB), and email Sessions Health support. Most imports take 1–3 days. Client contact and demographic details usually transfer. Billing history, insurance claims and remittances, and card data rarely do, and backfilled past appointments are not billable unless you update them.
So plan to finish posting old claims in the old system, and to move ERA enrollments to Sessions Health payer by payer once the old claims have mostly paid. After the import, check client status: if the export has no active flag, Sessions Health marks a client Active only when it finds a completed appointment in the past 90 days. Compare client counts before you shut off the old EHR.
Where Bomi fits
For Sessions Health practices we bill for, Bomi posts ERA and paper EOB payments to the claims, files secondary claims, and follows up on missing remittances. Billing is 4% of net collections; see pricing or contact us.
Related Guides
Frequently Asked Questions
Does Sessions Health post insurance payments automatically?
Yes, for payers you are enrolled with for ERAs. Sessions Health applies the ERA to the claim and marks it paid. Paper EOBs and payers without ERA enrollment still need manual entry.
Will enrolling for ERAs in Sessions Health stop them going to my old system?
Usually. Sessions Health says most payers send ERAs to one place, so enrolling there moves them away from wherever they went before. Time it for when old claims have mostly paid.
Does Sessions Health set up direct deposit (EFT)?
No. EFT is arranged with each payer through its portal or by phone. Insurance money goes straight to your bank; Sessions Health only receives the remittance.
My deposit arrived but there is no ERA in Sessions Health. What now?
Wait up to three business days. After that, confirm with the payer that your ERA enrollment is active, then send Sessions Health support the amount, date, and check or payment number.
Do my old claims and payments come over when I import into Sessions Health?
Rarely. Sessions Health says billing history, claims, and remittances seldom transfer. Finish old claims in the old system and keep a backup export.
Sources
Sessions Health: Insurance: Enrollments
Sessions Health: Claims: Remittance (ERAs and manual remittance)
Sessions Health: Claims: Secondary Claims
Sessions Health: Insurance: Pending Submissions Dashboard
Sessions Health: How to Record an Insurance Clawback or Reversal
Sessions Health: Insurance FAQs
Sessions Health: Problems with Claims and Enrollments
Sessions Health: Claims: Status
Sessions Health: Insights: Payments
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Founded by George Ruan, Dax Earl, and Andrey Goder, Bomi helps independent therapists and group practices with insurance billing, credentialing, and payer follow-up. Bomi grew out of Dax’s experience helping his mother with her therapy practice, with a clear purpose: reduce the administrative burden of insurance while keeping practice owners in control.
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