Get the free Connecticut Electronic Remittance Advice (ERA) Form

Reason for Submission (CHECK ONE)NEW Enrollment CHANGE Enrollment CANCEL EnrollmentReturn Completed Form to:Electronic Remittance Advice (ERA) Enrollment Foresail: ERAEnroll@mhealth.com Fax: 19499233597

How to fill out connecticut electronic remittance advice

How to fill out connecticut electronic remittance advice

1. Log in to your account on the Connecticut Medical Assistance Program website
2. Locate the 'Remittance Advice' section
3. Select the option to fill out electronic remittance advice
4. Enter the required information such as provider details, payment information, and claim details
5. Review the information entered for accuracy and completeness
6. Submit the electronic remittance advice form

Who needs connecticut electronic remittance advice?

1. Healthcare providers who receive payments from the Connecticut Medical Assistance Program
2. Billing departments or administrators responsible for tracking payments and claims

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What is connecticut electronic remittance advice?

Connecticut electronic remittance advice is a electronic notification that provides information about payments made by a healthcare insurance company.

Who is required to file connecticut electronic remittance advice?

Healthcare providers and facilities that receive payments from insurance companies in Connecticut are required to file electronic remittance advice.

How to fill out connecticut electronic remittance advice?

Connecticut electronic remittance advice can be filled out using a software program or online portal provided by the insurance company. It requires entering information about the payment received, including patient details, service provided, and payment amount.

What is the purpose of connecticut electronic remittance advice?

The purpose of connecticut electronic remittance advice is to provide transparency and documentation of payments made by insurance companies to healthcare providers. It helps in reconciling payments and tracking outstanding balances.

What information must be reported on connecticut electronic remittance advice?

Connecticut electronic remittance advice must include details such as patient name, date of service, procedure codes, payment amount, insurance company reference number, and any adjustments or denials.