May 2005 Newsletter

Remittance Processing Becomes More Efficient

By , VP of Information Systems, Partner

Streamlining the processing of remittance data is a great way to help any health care entity reduce expenses, increase accuracy and speed cash flow. HIPAA mandates that all payers provide electronic remittance advice in the standard ANSI 835 40.10A1 format. Well, not all payers are completely there yet, but they are making progress.

You might ask, what are these acronyms you are using? Let me explain them for you:

ANSI is the American National Standards Institute, a private, non-profit organization (501(c)3) that administers and coordinates the U.S. voluntary standardization and conformity assessment system.

835 is the transaction ID for electronic Health Care Claim Payment/Advice.

40.10A1 stands for the version of the 835 transaction, Version 4, Release 1, Sub-release 0, Addenda 1. 40.10A1 is the version that HIPAA requires the payers provide. ANSI creates new versions as needed. The new versions are generally born from business requirements.

Other terms you may see are ASC and X12. ASC is the Accredited Standards Committee and X12 is the term used for the EDI standards. ASC is chartered by ANSI to develop these standards.

If you are interested in the details of the 835 transaction, you can receive documentation from Washington Publishing Company.

OK, enough terms. How can this help you?

Quadax is now able to provide you with electronic remittance posting files from many more payers than ever before. Quadax is presently processing electronic remittance advice files in the ANSI 40.10A1 format from over 50 different payers, plus a few that are not yet on ANSI 40.10A1.

• By utilizing these electronic files, you can significantly reduce the amount of labor associated with posting these payments and denials by hand.
• In addition to the reduced labor, you will improve accuracy by eliminating manual keying errors.
• Your remittance processing will be completed much sooner, allowing your billing system to create secondary claims in a more timely fashion!

If you use HARP these electronic remittance files are loaded directly into the Remittance Processing System. For Xpeditor customers, this data is also loaded into the system and can be provided in the 835 format or proprietary posting formats, as your billing system requires.

Make sure you are utilizing electronic remittance from any payer for which you submit electronic claims. This number is constantly increasing, so keep checking our website and release notes for more payers.