Claims

Numeric tally of claim lines, services, or transactions included within a remittance advice batch or payment cycle. Used in provider billing and claims reconciliation systems to validate 835 EDI file completeness and ensure all submitted claims received a payment response.

The country associated with the payee or payer address recorded on an ERA/835 remittance transaction, used to support international claims processing, foreign provider payment workflows, and address validation during remittance reconciliation.

The system username or user identifier of the individual or automated process that generated the remittance record, providing an audit trail for ERA/835 transaction creation, manual payment posting entries, and data integrity tracking in billing systems.

The calendar date on which the remittance record was initially created in the system, either through automated ERA/835 ingestion or manual entry, used for audit tracking, processing lag analysis, and financial period assignment in claims management platforms.

The timestamp recording the exact time a remittance record was created in the system, used alongside the created date to provide precise audit trail documentation for ERA/835 transaction ingestion, payment posting, and workflow sequencing in billing systems.

The kidney function marker for a payment explanation. Used in healthcare data management and clinical workflows. This field is commonly used in electronic health records (EHR), healthcare information systems (HIS), and clinical data warehouses for remittance management and reporting.

The business date a remittance advice and associated payment are issued to a provider by a health plan or PBM. Used in provider AR, claims adjudication, and financial reporting systems to reconcile 835 EDI transactions, track payment timeliness, and support cash posting workflows.

The combined date and time value associated with a key event in the remittance lifecycle, such as ERA/835 receipt or payment posting, used for precise sequencing of remittance transactions and resolving processing order conflicts in claims reconciliation workflows.

The Drug Enforcement Administration registration number appearing in a remittance record, used to identify prescribing providers on pharmacy or controlled substance claims during ERA/835 adjudication reconciliation and compliance auditing in pharmacy billing workflows.

The date of death for a payment explanation. Used to track temporal information related to remittance death date. This field is commonly used in electronic health records (EHR), healthcare information systems (HIS), and clinical data warehouses for remittance management and reporting.

The dollar amount applied to a member's annual deductible as reflected on an ERA/835 remittance transaction, indicating the portion of allowed charges the patient must pay before insurance benefits apply, used to reconcile member cost liability and benefits accumulation.

The date a remittance advice record was logically removed from the payment processing system. Used in claims adjudication and payment reconciliation workflows to audit when an ERA or EOB record was voided, corrected, or purged from the remittance management system.

A flag identifying whether a remittance advice record has been logically deleted from the payment processing system. Supports claims payment audit trails by distinguishing active remittance records from those voided or superseded by corrected explanation of payment documents in adjudication workflows.

Free-text or standardized narrative explaining the payment action, adjustment reason, or denial rationale within a remittance advice record. Used in provider billing and claims systems to supplement CARC and RARC codes, supporting AR staff workflows and data engineer parsing logic.

The line-level payment information contained within a remittance advice, including claim-specific adjustments, denial reason codes, paid amounts, and contractual obligations. Maps to the 835 transaction set detail segments used by payers to communicate payment decisions to providers for each submitted claim.

The date by which a payer is contractually or regulatorily required to issue payment to a provider or beneficiary following claims adjudication. Used in accounts receivable management to flag overdue remittances and trigger follow-up actions in revenue cycle management workflows.

The elapsed time between remittance advice issuance and the corresponding payment settlement date. Used in payment cycle analytics and payer performance reporting to measure prompt payment compliance and identify delays between claim adjudication and actual fund disbursement to providers or members.

The date from which a remittance payment or adjustment becomes financially recognized within provider or payer accounting systems. Used in claims, provider billing, and financial reporting platforms to align payment posting with accounting periods and regulatory payment timeliness requirements.

The electronic mail address designated to receive remittance advice notifications or electronic remittance delivery confirmations. Used in payer-to-provider communication workflows to route 835 transaction delivery alerts and payment summary notifications to the appropriate billing or accounts receivable contact.

A flag identifying whether a remittance advice is associated with an emergency claim or requires expedited payment processing outside standard adjudication timelines. Used in revenue cycle systems to prioritize high-urgency payment postings and comply with emergency claim prompt payment regulations.