what is Remittance Voucher

Description

The remittance voucher displays the disposition of all claims processed during the claims cycle. A remittance voucher is mailed each week if the fiscal agent processed any claims or put any claims in “Suspend” status. If the provider receives payment by paper check, the check is mailed separately.

Role of the Remittance Voucher

The remittance voucher plays an important role in communications between the provider and Medicaid. It tells what happened to the claims submitted for payment–whether they were paid, suspended, or denied. It provides a record of transactions and assists the provider in resolving errors so that denied claims can be resubmitted.

The provider must reconcile the remittance voucher with the claim in order to determine if correct payment was received.

The remittance voucher contains one or more of the following sections, depending on the type of claims filed, the disposition of those claims, and any new billing or policy announcements:

·  Remittance Voucher Banner Page Message
·  Disposition Category by Groups
·  Summary Section

Remittance Voucher Banner Page Message

When Medicaid or the fiscal agent discovers billing problems encountered by all or selected provider types, a remittance voucher banner message is printed as the first page of the voucher. Suggestions for avoiding problems, explanations of policy, and new or changed procedure codes are described. Training sessions
are also announced on the remittance voucher banner page.

Disposition Category by Groups

Claims are listed by disposition category (paid, denied, or suspended) in alphabetical order by the recipient’s last name. Voids and adjustments are also listed separately.

Suspend Status

All claims in the “Suspend” status are reported each week until adjudicated as “Paid” or “Denied.” If one line on a claim form suspends, then the entire claim will suspend until all of the claim lines can be adjudicated.

Summary Section

The remittance voucher summary section reports the number of claim transactions, and the total payment or check amount. If the account shows a prior negative balance, it will be carried forward weekly until eliminated.

What is ERA payment and advantages of ERA payment

These days everyone is looking for ways to lower costs while increasing
productivity. Not always an easy task! But there is something available to
Medicare electronic billers that can help. The American National Standards
Institute (ANSI) Accredited Standards Committee (ASC) X12N 835 Electronic
Remittance Advice (ERA) is an electronic version of the Standard Paper
Remittance (SPR) sent from Highmark Medicare Services to a provider, vendor,
billing service or clearinghouse. Here are a few ways in which the ERA can save
time, money and increase productivity:

Save time by…

• No longer waiting for a paper remittance to arrive in the mail ERA provides finalized [paid and rejected] claim adjudication information on a daily basis in the ANSI ASC X12N 835 standard electronic data interchange (EDI) format.

• Having ERA available for retrieval from Stratus, Highmark Medicare Services’
telecommunications platform, for five business days The ERA can be reset as many times as needed during those five business days. Not ready to post right away? The ERA can be downloaded and saved in a folder for later use. However, once the five business day expire, the ERA is no longer available and cannot be reset. Therefore, it is a good idea to establish a routine to retrieve the ERA daily and post it promptly. If no claims finalize on a particular day, no ERA will be created.

• Arranging to receive your ERA directly even if you use a billing service or
clearinghouse

This is achieved by requesting an ERA receiver ID. Additional steps are
required to setup this option

Save money by…

• Generating less paper and lowering operating costs Once the ERA file is retrieved from Stratus, the ERA may be translated using software written by the vendor of your choice, created in-house, or by using free Medicare software like PC-Print™ (Part A) or Medicare Remit Easy Print (MREP) (Part B).

• Obtaining a free Medicare software product, PC-Print™ or MREP, which offer the ability to print the ERA in a format very similar to the hard copy SPR
This is especially helpful when you need to forward claim information to a secondary payer.

Increase productivity by…

• Using software products that may also offer the ability to automate the posting of the ERA to an accounts receivable system (check with a software vendor for availability) This means you no longer need to spend valuable time doing manual bookkeeping and generating patient bills. It can all be done for you electronically.

• Having data and administrative efficiencies available in the ERA that are not available in a SPR Although the information featured on the ERA and SPR is similar, the two formats are arranged differently, and the ERA offers some data and administrative efficiencies not available in an SPR.