When a Medicaid payer pays your claims, it sends a remittance file (an 835, also called an ERA). Uploading it to ALIS records the payment against your exported claims, marks them paid, and posts the payment to the general ledger. This guide covers posting a clean payment, where the payer paid every claim exactly as billed.
Note: Values and examples in this guide follow California Medi-Cal requirements.
Before You Begin
- GL Accounts: The claims payer type (e.g., Medi-Cal) should have a Primary Deposit (cash) account and an Accounts Receivable account saved in Billing Settings. If either is not mapped, ALIS still posts the payment, but the entry shows the account type name instead of your account number. See How Medicaid Claims Post to the General Ledger.
- Exported Claims: The claims in the 835 must have been exported from ALIS. How to Generate Medicaid Claims and Correct Rejected or Denied Claims.
- 835 file: Download the 835 from the payer’s portal or your clearinghouse. ALIS accepts .835, .txt, .edi, and .dat files.
Step 1: Upload the 835
Start on the Medicaid Billing page.
- Open Medicaid Billing from your navigation menu:
- Enhanced Navigation (sidebar): Billing > Resident Billing > Medicaid Billing
- Legacy Navigation (top menu): Billing > Medicaid Billing
- Click Upload ERA.
- Click Browse, or drag the file onto the window, and choose the 835 file.
- Review the preview: Payer, Payment Date, Total paid, Claims, EFT trace (TRN) and Payer ID. Confirm the total matches the payer’s deposit.
- Click Confirm. The Reconcile Remittance page opens.
Important: Once you upload an 835, its claims can’t be removed from their batches, even before you save. If you uploaded the wrong file, click Delete on the Reconcile Remittance page, then upload the correct one.
Step 2: Reconcile and save the remittance
Confirm every claim was paid as billed, then save to post the payment.
- Check the summary cards:
- Total Paid equals the Billed amount below it.
- Not Covered is $0.00, with 0 denied and 0 partial.
- Overpayment is $0.00, with 0 overpaid claims.
- FI Sequence shows the payment’s trace number, the same number shown as EFT trace (TRN) in the upload preview.
- Confirm the toggle reads Need Attention (0). If Need Attention shows any claims, see If Claims Need Attention below.
- Confirm each claim under All Residents toggle shows Paid fully.
- Click Save.
Important: A saved remittance can’t be deleted, saved again, or uploaded again. Reopening it shows the Reconcile Remittance page with Go Back instead of Save. The only action still available is Void on a denied claim.
If You Leave 'Reconcile Remittance' Before Saving
Use this section if you uploaded an 835 but didn’t save or delete it. ALIS keeps the uploaded file, but nothing posts until you save it. The batch’s RA Linked column shows the file with not yet saved below it, and the Paid column stays blank.
- In the the Export tab, click the 'not yet saved' file name.
- The Reconcile Remittance page opens. Do one of the following:
- To post the payment, continue with Step 2: Reconcile and save the remittance, or
- To remove the wrong file, click Delete at the top of the page, then click Delete to confirm.
Tip: If you don’t see the batch, adjust the Date Generated filter. It filters by the date the batch was exported, not the payment date.
After Saving the Remittance
Saving the remittance updates the claims, the batch, and the general ledger. Use these places to confirm the payment posted.
-
The batch shows the payment: On the Export tab, the batch’s Paid column shows the amount, and the RA Linked column lists the remittance. Click the file name to reopen the Reconcile Remittance page, or click Download to get the 835 again.
- Claims are marked Paid: On the resident’s Billing page, expand Invoices & Claims and click the Claims tab. The claim shows Paid, with the paid amount and the remittance in the Linked RA column. See How to Check a Resident's Medicaid Claims Status.
- The payment posts to the general ledger: ALIS posts one entry per resident per remittance file, debiting Primary Deposit and crediting Accounts Receivable. The entry is dated in the current month, even if the service month is closed. To find it, filter GL Transactions by the Claim Payment activity. See How Medicaid Claim Payments Post to the General Ledger.
- The Audit tab records the save, including any skipped claims and why.
If Claims Need Attention
Use this section when a payment isn’t clean. If the Need Attention toggle shows a number above 0, one or more claims weren’t paid exactly as billed. Find each claim status below to see how to address it.
Note: You can still save the remittance if items still need attention. ALIS posts only the claims paid in full. Every other claim is counted as skipped in the save message, and the Audit tab records why.
| Status or tag | What it means | What to do |
|---|---|---|
| Denied | The payer processed the claim and paid nothing. | Save the remittance, then void the claim to return its days to the Billing Queue. |
| Partially paid (tag: Underpaid) | The payer paid less than billed. | Nothing posts for this claim. Follow your community’s process for underpayments, such as an appeal or adjustment with the payer. |
| Overpaid | The payer paid more than billed. | Nothing posts for this claim. Follow your community’s process for overpayments. |
| Not fully reconciled (tag: Needs review) | The totals balance, but part of the payment couldn’t be matched to a billed day. | Expand the claim to compare services and dates. Contact the payer or clearinghouse if a service doesn’t match what you billed. |
| Not billed | The payer paid a service that doesn’t match a billed day in ALIS. | Check that service’s dates and procedure code against the claim. |
| Not found in ALIS | The file includes a claim ALIS doesn’t recognize. | Confirm the file belongs to this community and was billed from ALIS. If it doesn’t, click Delete before saving. |
Tip: Rejected claims never appear in an 835. Rejections come from the clearinghouse or payer portal before payment. See How to Generate Claims and Correct Rejected or Denied Claims.
Troubleshooting
| Issue | Troubleshooting Step |
|---|---|
| “This 835 appears to already be posted…” (when you click Confirm) | No action needed. This payment, identified by its trace number, has already been saved in ALIS. ALIS blocks it so the same payment isn’t posted twice. |
| “A remittance with trace number … has already been saved…” (when you click Save) |
Click Delete. This file duplicates a remittance already saved.
|
| “None of the claims in this remittance match a claim in ALIS…” (when you click Save) | Check the payer and file name, then click Delete. The file may belong to another community or billing system. The remittance isn’t saved. |
| “This remittance contains no claims, so there is nothing to reconcile.” (when you click Save) | Click Delete and request the correct file from the payer or clearinghouse. |
| “This file could not be read as a valid 835.” (when you upload) | Make sure you didn’t choose an 837 claim file by mistake. If the file is an 835, request a new copy from the payer or clearinghouse. |
| “N skipped. Reasons are in the Audit tab.” (after you save) | Open the Audit tab on the Medicaid Billing page to see why each claim didn’t post. For a Denied claim, see How to Generate Claims and Correct Rejected or Denied Claims. Handle partial and over payments according to your community’s usual process. |