Electronic Remittance
Electronic Remittance refers to the ability within MDsuite to:
- Receive the Explanation of Benefits (EOB) in electronic format
- Produce a paper EOB
- Produce an Exceptions Report
- Automatically transfer the payments and adjustments from the electronic EOB into the MDsuite Post Insurance Payment screen
- Allow the data (payments, adjustments, next responsible party, etc.) to be reviewed and/or modified
- Allow the payment and all associated data to be posted to all applicable accounts
Note: Electronic Remittance is sometimes referred to as Electronic Remittance Advice (ERA). The file you receive electronically is called an 835 file due to the ANSI Transaction Type for remittance being "835".
How it Works
- After clicking on Send/Receive in the MDsuite EDI Manager, MDsuite will receive any remittance files available from the Payer or Clearinghouse
- The remittance files appear in the Inbox and typically have an extension of 835; as long as the files fully comply with the HIPAA specifications, i.e., they are in the ANSI 4010 Addenda 1 format, they may then be processed by MDsuite
- Right-click on any conforming remittance file, then choose Process; MDsuite will start the Remittance Wizard, a step-by-step guide through the posting process
- On-screen preview shows how the remittance file will appear as a paper EOB; print this to keep on record
- View an Exceptions Report that highlights items that may need attention
- The Post Insurance Payment screen shows all payments and adjustments applied to the appropriate patients and charges
- Review the data and make changes, if necessary, then post
