Wis. ForwardHealth Online Handbook, Hospice, Topic #4745

Remittance Advice

The claims processing sections of the RA (Remittance Advice) include information submitted on claims and the status of the

claims. The claim status designations are paid, adjusted, or denied. The RA also supplies information about why the claim was

adjusted or denied or how the reimbursement was calculated for the payment.

The claims processing information in the RA is grouped by the type of claim and the status of the claim. Providers receive claims

processing sections that correspond to the types of claims that have been finalized during the current financial cycle.

The claims processing sections reflect the types of claims submitted, such as the following:

• Compound drug claims

• Dental claims

• Noncompound drug claims

• Inpatient claims

• Long term care claims

• Medicare crossover institutional claims

• Medicare crossover professional claims

• Outpatient claims

• Professional claims

The claims processing sections are divided into the following status designations:

• Adjusted claims

• Denied claims

• Paid claims