Stop Medical Claim Denials Before They Start.

For the best experience, we recommend using the latest version of Google Chrome on a desktop or laptop computer with a reliable high-speed internet connection. ClaimsRevenue™ is a data-intensive application designed to display detailed professional claim information, validation results, ERA data, and revenue analytics.

While you may be able to access ClaimsRevenue™ from a phone or small-screen device, Claims Validator™ and ERA Analyzer™ are not designed for mobile use. These tools contain wide tables, numerous data elements, and detailed claim and remittance information that cannot be presented effectively on a small screen. For accurate review and efficient use of the platform, a desktop or laptop computer is strongly recommended.

If you cannot find a raw 835 file inside your EHR or practice management system, your clearinghouse is often the easiest place to get it. The specific steps depend on which clearinghouse you use (Availity, Claim.MD, Office Ally, Optum / Change Healthcare, Waystar, TriZetto, Experian Health / ClaimSource). See the clearinghouse-specific FAQs below.

1. Log in to Availity Essentials.
2. Open the Send and Receive Files application.
3. Select your organization.
4. Open the ReceiveFiles folder.
5. Locate the ERA/835 files you want.
6. Select the Download icon for each file.

Availity identifies Electronic Remittance Advice files as 835 files. If you do not see ERAs, confirm that your practice is enrolled to receive ERA transactions through Availity.

1. Log in to Claim.MD.
2. Open View ERA.
3. Select the checkbox next to one or more ERAs.
4. Open Select Action.
5. Choose Download Selected 835.

Claim.MD downloads the original ERA in X12 format, commonly with a .x12 extension. That is the file you want for Claims Fingerprint.

1. Log in to Office Ally.
2. Select Download EOB/ERA 835.
3. Select the date containing the ERA files you need, or change the report mode to Monthly.
4. Locate the ERA.
5. Click VIEW in the Download/View column.
6. Office Ally downloads a ZIP file. Extract it.

The ZIP normally contains a .835 file (the original ANSI 835) and a .TXT file (a human-readable version). For Claims Fingerprint, use the .835 file.

If your remittances are available through Optum Pay, 835 files can be downloaded through the portal.

For practices with the Payment Data Files feature:

1. Open Payment Data Files.
2. Create a data bundle.
3. Select 835 as the file type.
4. Choose the settlement dates you want.
5. Choose the applicable payer or payers.
6. Create the bundle.
7. When processing is complete, return to Payment Data Files.
8. Select Download Data Bundle.

Optum also supports individual downloadable 835 files depending on your portal configuration and access level.

Open your Waystar remittance or Remit Manager workflow and locate the payer payment or ERA you want to analyze, then download the associated 835 remittance file.

Some Waystar configurations automatically deliver 835 files directly to your practice management system or an SFTP mailbox. If you can see the ERA but cannot download the native file, contact Waystar support and request: "The original X12 835 file associated with this remittance." Do not request only the human-readable EOB.

TriZetto frequently integrates directly with the practice management system, so the exact workflow varies by software configuration.

Open your TriZetto remittance or Send/Receive area and locate the electronic remittance files. The downloaded remittance may use a filename or extension determined by your practice management integration, but the underlying transaction should be an X12 835.

If you cannot locate a download option, contact TriZetto Provider Solutions and request: "The original EDI X12 835 remittance files for our TIN/NPI and requested date range."

Experian Health supports ERA/835 transactions through products including ClaimSource and eCare Online.

Log in to your ClaimSource or eCare environment and locate the electronic remittance transactions. If your account only displays a human-readable remittance and you cannot locate the original EDI download, open an Experian Health support case and request: "The native ANSI X12 835 ERA files for our practice." Make clear that you need the original EDI transaction rather than a PDF remittance report.

Ask whoever handles billing for your practice this simple question: "Where do our electronic remittance advice, or ERA/835 files, come from?"

Your billing manager, EHR vendor or billing service should be able to identify the clearinghouse. Once you know the clearinghouse, look for terms such as ERA, Electronic Remittance, 835, Remittance Files, Receive Files, or EDI Files.

No. A PDF Explanation of Benefits or printable remittance contains information from the 835, but it is not the original X12 transaction. For Claims Fingerprint, look for the raw 835/ERA file.

Possibly. Some systems, including Tebra/Kareo, save the original ANSI X12 835 as a .txt file. Open the file with a basic text editor. If you see structured X12 data beginning with segments such as ISA*..., GS*..., ST*835..., you likely have the raw 835 transaction. Do not convert the file to Excel, Word or PDF.

There is no required number of files. One 835 can contain multiple patient claims, while another may contain only a few.

Collect enough recent 835 files to give Claims Fingerprint a representative sample of your practice's claims, up to 1,000 claims. For most practices, using multiple remittance files will provide a much stronger picture than analyzing a single payment.

ClaimsRevenue AI is scoped to the claim in front of you and your practice's own ERA history. It is not a general-purpose chatbot. Every answer references a hit rate from YOUR actual denials for the specific payer, CPT, modifiers, and rendering provider on that claim. It will not opine on medical necessity, give legal or clinical advice, or recommend specific code changes.

Patient-identifiable data is scrubbed before any AI use, and no identifiable patient or claim data is used to train AI models.

Ask AI is charged $0.10 every time you submit a question. There is no waiver.

Revenue Max is only charged $0.50 when the free pre-screen determines a deep analysis is warranted and the deep analysis runs. If the pre-screen finds no material improvements likely, Revenue Max does not run a deep analysis and you are not charged.

AI is off by default on every account. The practice owner sets a monthly spending ceiling in Account Settings. $0 ceiling disables AI entirely. All charges roll up into one monthly invoice on the 1st of the following month alongside eligibility checks and the AMA CPT® royalty.

ClaimsRevenue™ is designed to support healthcare customers in workflows involving protected health information and enters into a Business Associate Agreement with covered customers. Customers remain responsible for their own HIPAA obligations and for using the platform in accordance with the BAA and Terms.

For more information, customers can review the U.S. Department of Health and Human Services HIPAA overview, which explains the Privacy, Security, and Breach Notification Rules.

Not at this time unless ClaimsRevenue LLC expressly authorizes that use in writing. 42 C.F.R. Part 2 is a federal confidentiality law that provides additional protections for certain substance use disorder treatment records. Customers are responsible for determining whether they are a Part 2 program or whether information they intend to submit is subject to Part 2. If you are unsure, contact us through live chat before submitting the information.

For more information, customers can review the U.S. Department of Health and Human Services overview of 42 C.F.R. Part 2, which explains the confidentiality protections for substance use disorder patient records. The full current regulation is also available in the federal Electronic Code of Federal Regulations, 42 C.F.R. Part 2.