EDI Report Types

EDI Report Types (Claims Status Awaiting Resolution Option)

There are a number of EDI Report Types available to monitor and manage electronic claims. TR reports provide the end-user with information to monitor and manage EDI claims still within the VA, that is, between the VAMC and the FSC in Austin, TX. The MM reports provide the end-user with information and feedback from parties external to the VA such as the clearinghouse and the various electronic payers.

Claims Status Awaiting Resolution – Synonym CSA

Billing and Accounts Receivable (or Accounts Management) staff use CSA to review the most current status messages and to perform follow-up actions on the bills. Electronic status messages, which include information and rejection messages from the clearinghouse or the payers, are accessed using this option. When is this option used? This is an option that must be checked Daily to determine which claims have rejection or warning messages that were returned from the clearinghouse or from payers. The cause for rejections must be resolved. This option should be used in conjunction with supporting reports (e.g. R022, R0SS, R0SC). The CSA report contains a Primary, Secondary and Tertiary sort capability and can be sorted by: A Authorizing Biller B Bill Number C Current Balance S Date of Service D Division E Error Code Text N Number of Days Pending M Patient Name P Payer R Review in Process L SSN Last 4 Once the CSA screen list is displayed, users can select new sort criteria and re-sort the list without exiting the option. Reports can be run showing rejections only (R), or both informational and rejection messages (B). Users most often run the CSA report to show rejections only so they can focus on those claims that require corrective action. These messages are automatically assigned a status of Not Reviewed and require users to review them and make corrections to update this status in IB. Users select a bill from the list to view the details and the entire message text. Messages are marked as reviewed or review in process. Users may document comments.

To learn more about EDI and become a certified  EDI Professional please visit our course schedule page.

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