📝 Overview
A Failed ERA is a file ChiroHD received but couldn't fully process into EOBs. The file is not lost — in most cases, a correction allows it to be reprocessed successfully without contacting support.
Failed ERAs appear under the Failed tab in the ERAs section of the Insurance Dashboard. Click any row to expand it and see the specific error reasons.
Troubleshooting: ERA File Not Appearing in ChiroHD at All?
What to do if an ERA file that exists in your clearinghouse but doesn't appear anywhere in ChiroHD — not under Failed, not under Processed.
1. Already Resolved
Search the Processed tab, check "Show Manually Entered"
2. File Extension Mismatch
Most common hidden cause — no error shown. (See clearinghouse/extension table in this video)
3. File Not on SFTP Server
Visible in portal ≠ on SFTP. Confirm with clearinghouse the file is on the SFTP location.
4. Wrong SFTP Credentials
Test at: Settings → Initial Setup → Integrations → Clearinghouse
5. Sync Start Date
Confirm the file date is on or after your configured sync start date. (You can find this in Settings, Initial Setup, Integrations, Clearinghouse)
6. Too Recent
Allow up to 30 minutes for ChiroHD to pull new files.
If the file still does not appear after completing the troubleshooting steps, contact ChiroHD Support and provide the file name, clearinghouse name, and date of the ERA file.
Accessing Failed ERAs
Navigate to Insurance in the top navigation bar, then select Insurance Dashboard.
In the bottom portion of the Insurance Dashboard, you will see the ERA section. Click beside the ERA blue file to open the ERA card and display the errors.
At the top right of the ERA section, use the toggle buttons to switch between Failed and Processed. Select Failed to view all ERAs that did not process successfully.
Reviewing Error Details
Each failed ERA displays an error count in the Errors column. To see what went wrong:
Click anywhere on the ERA row to expand it.
The error details will drop down beneath the row, listing each specific issue that prevented the ERA from processing (e.g., unknown patient, service not found, modifier mismatch, unknown reason code).
Review the error messages carefully — they identify exactly what needs to be corrected before reprocessing.
💡 Tip: If you click Attempt Reprocess ERA and no errors appear, click the ERA row itself to expand the hidden detail section.
Fixing and Reprocessing a Failed ERA - Common Error Types
Once you've identified the error type, ChiroHD offers inline fix options directly on the ERA card:
Error Type 1: Patient Not Found
What it looks like:
Unable to find a matching patient name or patient insurance alias for: John, Smith
Why it happens:
The patient name in the ERA file doesn't match any patient record in ChiroHD. This is very common and almost always fixable by the office without contacting support. Causes include hyphenated vs. non-hyphenated names, maiden vs. married name, abbreviations, or minor formatting differences from the payer.
How to fix:
In the expanded error row, use the patient type-ahead search to find the correct patient in ChiroHD
Select the patient — ChiroHD creates an Insurance Alias mapping that name variation to that patient
Future ERAs from the same payer with that name will match automatically
Click Attempt Reprocess ERA
If you need to correct the patient's actual name in ChiroHD rather than creating an alias, update the patient record first, then reprocess
Viewing & Managing Patient Insurance Aliases
When ChiroHD resolves a patient-matching error on the Failed ERAs page, it automatically saves the name from the EOB as an insurance alias on that patient's record — so future ERA files with the same name will match automatically.
To view the aliases saved for a patient, navigate to their profile, select Cases, click the Insurance tab, and scroll to the Patient Insurance Aliases table at the bottom. Each row shows the alias name exactly as it appeared on the ERA, along with a Delete button to remove it if it was created in error.
NOTE: Aliases are stored per patient — there is no office-wide list. You can only view them from the individual patient's profile.
Error Type 2: Service Not Found / Modifier Mismatch
What it looks like:
Service (98941-AT) not found for Jane Doe on 2025-10-12
Why it happens:
ChiroHD matched the patient but couldn't find a matching service. The service must match on CPT code, modifiers, and date of service. Causes:
Modifiers don't match exactly
The service was voided after the claim was submitted
The service was moved to a different case type after billing
How to fix:
Review the error — it shows what the ERA contains vs. what ChiroHD has
For modifier mismatches: choose to update the service item or create a modifier override using the inline options
For voided/moved services: go to the patient's Transactions Ledger, click Show Voided Items to see if the service was voided. Correct the ledger so it matches what was billed, then reprocess
If you need to review the ERA file directly, click the file name — it will download as a ZIP containing an 835 file and a readable text file. Search the text file for the patient name to see exactly what the payer reported
Error Type 3: Duplicate Services Found
What it looks like:
Duplicate services (98941-AT) found on 2024-10-12 for John Smith
Why it happens:
ChiroHD found more than one service that matches the ERA service line and can't determine which one to use. Causes:
The same CPT code was billed twice on the same date
A service was billed with multiple units in ChiroHD, but the payer returned it as individual service lines
How to fix:
Go to the patient's ledger and review the date of service shown in the error
Look for duplicate services with the same CPT, modifiers, and date
Void or correct duplicates as appropriate
If the issue is multi-unit billing, confirm that how you billed in ChiroHD matches how the payer is returning the data
Reprocess after corrections
Error Type 4: Missing Service Date
What it looks like:
Missing service date, please forward this ERA to your clearinghouse and request segment DTM*472
Why it happens:
The clearinghouse omitted the service date segment (DTM*472) from the ERA file, or it's malformed. ChiroHD requires this segment to match services correctly.
How to fix:
Contact your clearinghouse and request that they correct the ERA
Ensure all future ERAs include the DTM*472 segment
Reprocessing will NOT resolve this error
This is a file structure issue. ChiroHD cannot infer or guess service dates
The fix must come from the clearinghouse
Error Type 5: Unknown Adjustment / Reason Code
What it looks like:
Unknown adjustment code | reason code combination found in ERA - CO : 123
Why it happens:
The ERA contains a Group Code + Reason Code combination that ChiroHD has no default behavior for.
How to fix:
Escalate to ChiroHD Support
Engineering will review and add the appropriate default behavior
Once added, reprocess the ERA
If your office wants a reason code handled differently than the default, use a custom reason code behavior (covered in Video 5)
An unknown code with no behavior at all requires engineering involvement
Once any inline fixes are applied, click Attempt Reprocess ERA to re-run the ERA against the corrected data.
When Reprocessing Helps vs. Doesn't
Keep in Mind: Reprocessing re-runs the ERA against your current configuration and billing data. It does not modify the ERA file itself.
✅ Reprocessing helps when:
You've created or updated an insurance alias
You've corrected invoice/ledger data
You've added or updated a reason code behavior
⚠️ Reprocessing does NOT help when:
The ERA file is structurally invalid
Required X12 segments are missing (like DTM*472)
The service was never billed or was billed incorrectly and hasn't been corrected yet
Clearinghouse SFTP credentials or configuration are wrong
If reprocessing repeatedly fails with no change in the error, stop and assess whether the fix needs to happen outside of ChiroHD before trying again.
Marking an ERA as Manually Entered
If an ERA cannot be reprocessed and you need to clear it from the Failed list urgently, you can post the EOB manually and then mark the ERA as handled:
Post the EOB manually in ChiroHD as you normally would.
Return to the Failed ERA list and locate the ERA.
Click Mark as manually entered in the Actions column.
Confirm when prompted.
The ERA will be removed from the Failed queue.
NOTE: Use this only when the EOB has genuinely been posted manually — not to clear items without taking action on them.
Reprocessing a Failed ERA After Updating a Behavior
To apply a new or updated behavior to an ERA that previously failed or allocated incorrectly:
Navigate to your Live Location, Insurance Tab, Insurance Dashboard.
Find the affected ERA in the Failed tab, or the affected EOB in EOB History.
Click Attempt Reprocess ERA.
ChiroHD re-runs the ERA with the updated behavior mapping. Custom behaviors take effect on the next ERA processing run — they do not retroactively update already-processed EOBs. If all errors are resolved, the ERA moves out of Failed and the resulting EOB(s) appear in Pending EOBs for your team to review and finalize.
When to Escalate to Support
Contact ChiroHD support when:
A file exists in the clearinghouse SFTP server but never appears in ChiroHD (please allow at least an hour for the file to load)
An Unknown Error message appears when reprocessing
When escalating, include:
Your location name
ERA file name
Exact error message displayed
Troubleshooting steps already attempted
Please see our other resources on How to Contact ChiroHD Support for the methods and up to date contact information.
✅ Key takeaways
Most ERA errors in ChiroHD can be fixed with patient mapping, ledger corrections, or modifier updates.
Missing ERAs are often due to file extension mismatches, SFTP issues, or configuration problems.
Reprocess after making data corrections; do not reprocess files with missing key segments.
Use "Mark as Manually Entered" only after physical posting; not for unaddressed items.
Escalate only after all troubleshooting steps are exhausted, with all relevant details included.
📌 Conclusion
This guide provides a structured process for identifying, correcting, and escalating ERA-related errors in ChiroHD. By following these steps, you can efficiently resolve most issues, ensuring accurate ERA processing and minimal manual intervention.