How to Read the Remittance Advice

• Overview and sample Remittance Advice
• Remittance Advice tutorial

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A Remittance Advice (RA) is an automated paper notice you receive from the Division of Medical Assistance Programs (DMAP) telling you about payment or other claims actions. Claims that are “in process” will not appear on your RA.

Overview and sample Remittance Advice

1. Your provider name and provider number.
2. The date the RA was printed. It will be the same date on your check. Refer to this number if inquiring about an RA.
3. The unique number DMAP assigns to each RA; however, when inquiring about the RA, refer to the date of the RA (see #2) rather than this number.
4. The sequential page number for this RA.
5. The clients’ names in alphabetical order.
6. The clients’ recipient ID numbers.
7. This is the unique number assigned by DMAP to each claim during processing. Reference this number when completing the adjustment form.
8. If a patient account number was listed on the claim form, it will be printed in this space.
9. The date of service listed on the claim form. The type of service and procedure code listed on the claim form.
10. The type of service and procedure code listed on the claim form.
11. The number of services billed for this procedure code on the claim form.
12. The amount billed for this service on the claim form.
13. The amount paid by another source, such as, patient liability, private insurance, or Medicare.
14. The amount paid by DMAP.
15. These numbers correspond to the written messages in the lower portion of the RA.
16. Subtotals from the billed amounts, third party liability (TPL) credits applied, and DMAP payment amounts on this RA.
17. This section contains payment information in two columns: "Current" (payments this RA) and "Year to Date" (all payments this calendar year).
18. Claims Message Codes, also called Explanation of Benefits (EOB): Computer messages that indicate how the claim was processed, if more information is needed to process the claim, or if payment was denied.

Remittance Advice Tutorial

The following slideshow provides an overview of claims processing, when you will receive an RA, how to read the RA, and appropriate actions to take when you receive an RA for underpaid, overpaid or denied claims.

How to read a Remittance Advice:   PDF or Powerpoint

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