Health Care Payment/Advice (Remittance Advice)
The 835 ERA is the electronic version of the paper remittance advice. It contains an explanation of claims payments, claims denials, and other financial information necessary for providers to reconcile patient accounts.
CARCs and RARCs display on the 835 ERA. They identify standard reasons why payment may be different than the submitted charge. CARCs and RARCs are mandated by HIPAA-AS and the code definitions cannot be changed by BCBSF or any payer. CARC definitions tend to be generic while RARC definitions provide more information related to adjudication of the claim. HIPAA-AS requires that for every five CARCs displayed on the 835 ERA at least one RARC must be returned as well to provide clearer information when claim payments are denied or reduced. To obtain the most recent and complete list of CARCs and RARCs, visit the Washington Publishing Company website.
Providers can receive ERAs delivered to their Availity Receive Files mailbox or other mailbox as desired. Some billing systems can import the information to automate posting of accounts receivables. Providers interested in receiving ERAs should follow the instructions on the 835 Health Care Electronic Remittance Advice (ERA) Request Form
The Availity Remit Reader enables users to view, search, reconcile and print Electronic Remittance Advice (ERA) or 835 files. Florida Blue proprietary information is included with the HIPPA 835 data. Availity will store up to 7 years of the remit information within the Remit Reader. This solution replaces the paper remittance and is available the same day the financial cycle is completed at Florida Blue. This tool makes it easier to search and locate information and sort by Check/EFT, Patient and Claim data. A PDF document can be generated for printing or saving capabilities.
To utilize the Remit Reader tool, an Availity registration is required. Registration, along with training, are free of charge and can be obtained by visiting www.availity.com