How to Read the ND Health Enterprise MMIS Remittance Advice
Enterprise Remittance Advice (RA) notices are produced as the final step of the weekly (or as otherwise scheduled) payment cycle. RAs are available as a PDF accessed via the provider web portal, EDI 835 transaction file routed to authorized trading partners, or paper documents printed and mailed on a very limited exception basis.
The RA includes detailed information on finalized claims (paid or denied); including the total amount of provider payment for all finalized claims within the financial cycle period. Providers may elect to receive information on suspended claims also if desired. Itemized information reported on the remittance advice for each claim detail and claim total assist the provider in tracking adjudication decisions necessary for patient account update and claim resubmission as appropriate.
The RA report includes detailed information on adjustments made to previously finalized claims, as adjustments can happen at the line, claim or provider level.
Changing RA Delivery Method
Although the information that the two formats provide is alike, the electronic format offers administrative efficiencies not available in a paper format. Submit a request, including your 7-digit Medicaid ID(s) to email@example.com to change your preference.
Reason/Remark Codes Used by ND Medicaid
General Remittance Advice Information
Understanding Unique Remittance Advice by Claim Type
The following materials provide field level descriptions of a remittance advice, by claim type.