3 Replies Latest reply: May 15, 2014 10:14 AM by Joe Berry RSS

    Remittance Advice 835 File

    rlujan609 _

      Hi All,

       

      I work in a hospital and I am trying to build a template for 835p Remittance advice file that I get from Medicaid. What I would like to do is extract the payment information. I am very new to Monarch never been trained and I have version 8.01 I been trying to create the templates but I was wondering if any one had template create already that I could use to guide and use.

       

      Below is an example - I would to take some demographic patient info and level payment information. The first template I created took the patient name, account number, total charges (on line 16) the second template I got from line 23 to 38 but how do I capture line 24 and 25 which are part of line 23. So I view the data table form but I am only getting the first line of each account for both templates I am not getting all the data per remitt. Sorry I hopefully I didn't confuse anyone just pretty new at this and I need this so that I could dump it on database and analysis payment information.

       

      Any assistance will be greatly appreciated

       

       

      PAYMENT DATE: 09/28/11              NYCHHC - JACOBI MEDICAL CENTER     1679587679                   RUN DATE: 09/29/11    PAGE     1

      NY MEDICAID

                                        ELECTRONIC MEDIA REMITTANCE ADVICE DETAILED OUTPATIENT LISTING

      ===================================================================================================================================

      PATIENT       |PAT CNTRL NBR-UNIT  |FROM DT|COST|REPT CHGS |DRG NBR|OCD|DRG CAP AMT|COINS AMT  |PRIMARY PAY|HCPCS AMOUNT|INTEREST

      ICN NUMBER     |POL NUMBER         |THRU DT|COVD|NCOVD CHGS|DRG AMOUNT |OUTLIER AMT|MSPLIAB MET|PROF COMP  |OTH ADJ AMT |PAT REFUND

      CLAIM #|CLM ST|MRN NUMBER          |PT STAT|NCVD|DENIED CHG|DRG OPR AMT|DEDUCTIBLE |REIMB RATE |ESRD AMOUNT|CONT ADJ AMT|NET. REIMB

      COINS DAY|LTR DAY |OUTL DAY |IND TEACH|DISP SHARE|COVD CHGS|TOB|CLAIM REFERENCE NUM           | NEG REIMB      CO-PAY AMT

      RCODE1|RCODE2|RCODE3|RCODE4|RCODE5 |

      GCD1|ACD1|  ADJAMT1  |GCD2|ACD2|  ADJAMT2  |GCD3|ACD3|  ADJAMT3  |GCD4|ACD4|  ADJAMT4  |GCD5|ACD5|  ADJAMT5  |GCD6|ACD6|  ADJAMT6

      CHECK/EFT NUMBER     |                                           |CROSS-OVER PAYER NAME|

      COMMENT 1            |                                           |COMMENT 2            |

      -


      +

      SVC|REV CD  |DATE  |HCPCS/HIPPS|MODS|UNIT/VISIT|      CHARGES |    ALLOWED |GC |RSN   |     AMOUNT  |REMARK CODES/APC

      -


      +

      HINKSON    J   000325362757EMRM4101 010311  000     4268.49                     .00         .00         .00         .00         .00

      268000014       VB87952N            010311    0         .00         .00         .00         .00         .00         .00         .00

            1    1   325362757EMR4            XX    0         .00         .00         .00         .00         .00     3795.94      458.83

          0       0        0            .00        .00        .00 13   1126400022079920                        .00         .00

      CO 94       -1833.92  CO 45        3807.14  CO 97        1822.72  CO 204         13.72

      021300071911033

      RATE CODE 1402

      SVC          01/03/11  70450                  1      1094.89       198.26   CO  94          11.20-                00299

                                                                                  CO  45        2730.55

                                                                                  OA  94        1822.72-

      SVC          01/03/11  99284     25           1      1250.86       190.66   CO  45        1060.20                 00674

      SVC          01/03/11  86900                  1        26.45        31.81   CO  45           5.36-                00393

      SVC          01/03/11  80053                  1        33.40        22.19   CO  45          11.21                 00403

      SVC          01/03/11  86901                  1        26.45        15.91   CO  45          10.54                 00393

      SVC          01/03/11  81001                  0        11.08          .00   CO  97          11.08                 00410

      SVC          01/03/11  70480                  0      1436.84          .00   CO  97        1436.84                 00301

      SVC          01/03/11  85730                  0        20.95          .00   CO  97          20.95                 00406

      SVC          01/03/11  71020                  0       205.45          .00   CO  97         205.45                 00471

      SVC          01/03/11  86850                  0        73.70          .00   CO  97          73.70                 00394

      SVC          01/03/11  85025                  0        27.15          .00   CO  97          27.15                 00408

      SVC          01/03/11  85610                  0        13.72          .00   CO  204         13.72                 00999

      SVC          01/03/11  36415                  0        14.44          .00   CO  97          14.44                 00457

      SVC          01/03/11  86880                  0        33.11          .00   CO  97          33.11                 00394

      ===================================================================================================================================

      DELGADO    J Z 000350300870EMRM4101 010311  000     1626.28                     .00         .00         .00         .00         .00

      268000014       PG81249D            010311    0         .00         .00         .00         .00         .00         .00         .00

            2    1   350300870EMR4            XX    0         .00         .00         .00         .00         .00     1445.82      180.46

          0       0        0            .00        .00        .00 13   1126300000198620                        .00         .00

      CO 94       -1162.05  CO 45        1457.02  CO 97        1150.85

      021300071911033

      RATE CODE 1402

      SVC          01/03/11  99243     27           1       475.43       180.46   CO  94          11.20-                00576

                                                                                  CO  45        1457.02

                                                                                  OA  94        1150.85-

      PAYMENT DATE: 09/28/11              NYCHHC - JACOBI MEDICAL CENTER     1679587679                   RUN DATE: 09/29/11    PAGE     2

        • Remittance Advice 835 File
          rlujan609 _

          This is not how it looks there is a lot spacing between.

            • Remittance Advice 835 File
              Olly Bond

              Hello rlujan,

               

              You can get reports to post nicely here in the forums by putting them between CODE and /CODE tags in square brackets - as per my signature. For general template questions, that's probably the best first step. For expert advice on 835's, I would suggest contacting either Datawatch themselves who announced something a few months ago, or Joe Berry here on the forum.

               

              Best wishes,

               

              Olly

            • Remittance Advice 835 File
              Joe Berry

              Healthcare 835's - electronic remit files - can be done in several ways.  One is to parse the EDI file directly.  I do not use that method. 

               

              I have used one of two free programs to convert the files from the 4010 or 5010 EDI standard to a pdf.  From the pdf file I am able to extract the data using Monarch.  The two free programs are PCPrint and Medicare Remit Easy Print.  As far as I know the most current version of PCPrint is 4.2 and the most current version of Medicare Remit Easy Print is 3.2.4.  Both will print 835's that are 4010 or 5010 compliant from any payer.

               

              Hope that helps.