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How to Read the Paper Remittance Advice

How to Read the Paper Remittance Advice

Learn how to read and take action on the claim status information listed in this automated paper notice from DMAP.

Questions and answers about the paper remittance advice (RA)

Answer
What is in the paper remittance advice (RA)?
Information in the RA will appear in the following order, as applicable:
  • Banner messages: Messages from DHS/OHA
  • Paper check: If you don't want a paper check, sign up for direct deposit.
  • Claim information: By type of bill and Internal Control Number (ICN) - paid, denied, in process, adjustments
  • Third-party liability (TPL) information: Third-party resources for each client, in order of ICN
  • Financial transactions: Non-claim-specific payouts to or refunds from providers; accounts receivable information
  • Leverage Claims Payable - Not paid: Lists the claims the providers must pre-pay before DMAP can process them. Learn how to read this section and your RA summary to find out how much you need to pay. 
  • Summary: All activity reported to the RA
  • EOB Code Descriptions: For all the Explanation of Benefit (EOB) codes listed in the RA
Are there other ways to get claim status information?

Yes. These systems use HIPAA-compliant Claim Adjustment Reason Codes and/or Remittance Advice Remark Codes to describe the status of a claim.

I want to stop receiving the paper remittance advice (RA). How do I do this?

Contact Provider Services (800-336-6016) and ask to stop receiving the paper RA. Please provide the Provider ID listed in the "Payee ID" or "NPI ID" field in the top right corner of the paper RA.​


Quick references and self-study guides

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Common FFS billing errorsThis list shows whether the EOB is informational or if it requires action on your part.
How to read the Leverage Claims Payable - Not Paid section of the paper RAThis section lists the claims the providers must pre-pay before DMAP can process them. Learn how to read this section and your RA summary to find out how much you need to pay.
How to read the paper remittance adviceAlso learn how to resolve underpayment or overpayments reported on the paper RA.
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