EHR › Revenue Cycle
Claims EDI
Claims to the clearinghouse, acknowledgements and remittances back, and eligibility.
In EHR → Revenue Cycle · 6 screens
ViewEDI FilesEvery X12 interchange with the clearinghouse: 837P and 837I claims and 270 inquiries out; 999, 277CA, 835 and 271 in. Control numbers, counts and the raw file.OpenViewRemittancesElectronic remittance advice (835): the payment, the claims it pays, the adjustments and the patient's share, posted to the claims, and whether it all balances.OpenViewClaim AdjustmentsEvery adjustment a payer made on a remittance, by group and reason code (CARC) with its remark codes (RARC).OpenViewEligibility ChecksEach 270 inquiry and the payer's 271 answer: coverage, plan, copay, deductible and what is left of it, coinsurance and out-of-pocket.OpenRecordsClearinghouse PayersThe payer ids a clearinghouse routes to, and which transactions each takes.OpenRecordsPractice SitesWhere prescribers write from and claims bill from: the group NPI, tax id, taxonomy and address that NCPDP and X12 carry.Open
Columns, fields and actions
| Screen | Kind | What it is | Columns | Fields | Actions |
|---|---|---|---|---|---|
| EDI Files | Read-only list | Every X12 interchange with the clearinghouse: 837P and 837I claims and 270 inquiries out; 999, 277CA, 835 and 271 in. Control numbers, counts and the raw file. | 10 | 0 | 3 |
| Remittances | Read-only list | Electronic remittance advice (835): the payment, the claims it pays, the adjustments and the patient's share, posted to the claims, and whether it all balances. | 12 | 0 | 3 |
| Claim Adjustments | Read-only list | Every adjustment a payer made on a remittance, by group and reason code (CARC) with its remark codes (RARC). | 9 | 0 | 0 |
| Eligibility Checks | Read-only list | Each 270 inquiry and the payer's 271 answer: coverage, plan, copay, deductible and what is left of it, coinsurance and out-of-pocket. | 11 | 0 | 0 |
| Clearinghouse Payers | List | The payer ids a clearinghouse routes to, and which transactions each takes. | 8 | 10 | 0 |
| Practice Sites | List | Where prescribers write from and claims bill from: the group NPI, tax id, taxonomy and address that NCPDP and X12 carry. | 7 | 14 | 0 |