Coordination of Benefits HIPAA Basics Coordination of Benefits requirements and basic procedure descriptions subject to the rules of the X12 837 HIPAA Technical Reports Type 3 (TR3s) as the national standard for provider electronic submission of health care claims to payers such as Medicare. It also contains the requirements for electronic transfer of claims from Medicare to … Read More →
Health Care Payment: Electronic Remit Advice and Standard Paper Remit Health Care Payment with Electronic Remit Advice (ERA) has a number of advantages over Standard Paper Remit (SPR). The amount payable for each line and/or claim as well as each adjustment applied to a line or claim can be automatically posted to accounting or billing applications from an … Read More →
Health Care Payment and Remittance Advice Health Care Payment information is reported within ERA (Electronic Remit Advice) or SPR (Standard Paper Remit). After Medicare processes a claim, either an Electronic Remit Advice or a Standard Paper Remit is sent with final claim adjudication and payment information. One Electronic Remit Advice or Standard Paper Remit usually … Read More →
ASCA Waiver Application Guidelines For Providers ASCA Waiver Application guidelines describe some situations when this electronic billing requirement could be waived for some or all claims, but a provider must obtain Medicare pre-approval to submit paper claims in these situations: Any situation where a provider can demonstrate that the applicable adopted HIPAA claim standard does not … Read More →