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1304 Vermilion Street ? Hastings, MN 55033 pH 800-482-3518 ? Fax 651-389-9152 www.edsedi.com NEBRASKA MEDICAID DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION CKNE1 PAYER ID NUMBERS
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How to fill out paper remittance advice statements
How to fill out paper remittance advice statements:
01
Gather all necessary information, such as patient details, payment amounts, and procedure codes.
02
Start by entering the patient's name, address, and contact information in the designated fields on the form.
03
Indicate the healthcare provider's name, address, and contact information next.
04
Record the date of service for each procedure or medical service provided.
05
Enter the corresponding procedure code or CPT (Current Procedural Terminology) code for each service rendered.
06
Include the payment amount received for each procedure, as well as any adjustments, discounts, or deductions.
07
Total up the payment amounts and ensure that they match the check or payment received.
08
If necessary, provide any additional explanations or comments in the designated section.
09
Review the completed paper remittance advice statement for accuracy and completeness before submitting it for processing.
Who needs paper remittance advice statements?
01
Healthcare providers: Paper remittance advice statements are necessary for healthcare providers to keep a record of their services, payments received, and any adjustments made.
02
Insurance companies: Insurance companies require paper remittance advice statements to reconcile payments and ensure proper reimbursement.
03
Patients: Paper remittance advice statements provide patients with an overview of the services they received and the associated costs, enabling them to validate their insurance claims and track their healthcare expenses.
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What is paper remittance advice statements?
Paper remittance advice statements are paper documents that provide details of payments made by a payer to a payee.
Who is required to file paper remittance advice statements?
Certain businesses, organizations, and individuals who receive payments may be required to file paper remittance advice statements.
How to fill out paper remittance advice statements?
Paper remittance advice statements can be filled out manually by including relevant payment details such as the date, amount, and purpose of the payment.
What is the purpose of paper remittance advice statements?
The purpose of paper remittance advice statements is to provide documentation of payments made and received.
What information must be reported on paper remittance advice statements?
Paper remittance advice statements must include payment details such as the date, amount, and purpose of the payment.
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