How to Read the Remittance Advice

Questions and answers about the remittance advice

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

What is in the paper remittance advice (RA)?

Information in the RA will appear in the following order, as applicable:

Banner messages: Messages from ODHS/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 OHA 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.

Automated Voice Response (866-692-3864) will read you information about the first six claims for the ICN or client ID you request claim status on. After that, you need to use the Provider Web Portal for additional information. For more information, refer to the AVR Quick Reference.
The Provider Web Portal at https://www.or-medicaid.gov allows you to view PDF versions of the paper remittance advice. You can also review and adjust, void or resubmit claims as necessary. For more information, view the Claim Adjustment Handbook and the step-by-step instructions.
Electronic Remittance Advice (ERA or 835 transaction) – Through OHA or a registered clearinghouse. Current electronic data interchange trading partners can sign up for the electronic RA (check the box for "835 Health Care Claim Payment/Advice"). Providers new to EDI can learn how to get started.

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

If you have the "Online RA" role in the Provider Web Portal at https://www.or-medicaid.gov, you can stop the paper RA by clicking the "Stop Paper RA" button when you first access the Online RA screen.

If you do not have Provider Web Portal access, you can also contact Provider Enrollment (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.

How to Read the Remittance Advice

Questions and answers about the remittance advice

What is in the paper remittance advice (RA)?

Are there other ways to get claim status information?

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

Quick reference and self-study guides