Complete Remit Analysis (REM)

Complete Remit Analysis (REM) provides insight into both matched and unmatched payments, denials, and adjustments from the payer. The summary tab accounts for all differences between the billed and payer payment amount. The adjustment tabs provide details on the types of adjustments codes received at a claim and service line level both at a summary and claim-level.

Business Use

View and analyze data based from actual remit adjustments.

Running the Report

To generate the Complete Remit Analysis (REM) report:

  1. Click Run on the Complete Remit Analysis (REM) report pod.
  2. Select one or more CIDs from the values displayed.
  3. Use the calendar function to enter a Payment Date (Start).
  4. Use the calendar function to enter a Payment Date (End).
  5. Click Run Query.

Tab Views and Field Descriptions

See the following pages for details on these tabs:

This tab accounts for all differences between the billed and payer payment amount.

Column Description
Total Claim Count Total count of claims.
Total Billed Amount Total value billed to Payer.
Denied Charges Total amount denied by Payer.
Contractual Adjustments Contractual or regulatory amounts associated to the service provided.
Bundled Charge Adjustments Amount of services inclusive to procedure but not separately payable.
Prior Payment Adjustments Payments made by previous payers subtracted from payments being made by the current payer.
Patient Responsibility Amount assigned to the patient.
Total Payer Payment Total claim payment.

This tab reports on remit adjustments that occurred at the claim level. The adjustments are summarized at a payer, group code, and adjustment code level for Institutional and Professional claims. The tab allows for high level analysis of the types of adjustments impacting the claims.

Column Description
Payer Name of payer designated on the claim.
Claim Adj. Category Category of adjustment made on the claim.
Claim Adj. Group Code Code indicating category of adjustment made on the claim.
Claim Adj. Code Code indicating reason for claim adjustment.
Claim Adj. Information Description of claim adjustment.
Claim Adj. Amount Dollar amount by which adjustment was made.
Claim Adj. Qty Number of times claim was adjusted.
Number of Claims Total claim count for the selected payer adjustment code.

This tab reports on remit adjustments that occurred at the service line level. The adjustments are summarized at a payer, group code and adjustment code level for Institutional and Professional claims. The tab allows for high level analysis of the types of adjustments impacting the claims.

Column Description
Payer Name of payer designated on the claim.
Service Line Adj. Category Code indicating category of adjustment made on the service line.
Service Line Adj. Group Code Code indicating reason for service line adjustment.
Service Line Adj. Information Description of service line adjustment.
Service Line Adj. Amount Dollar amount by which adjustment was made.
Service Line Adj. Qty Number of times service line was adjusted.
Number of Service Line Adj. Remit service line adjustment count for the selected payer adjustment code.

This tab reports on remit adjustments that occurred at the claim level. The adjustments are reported at the claim level. Claim level details allows for deep dive analysis from the summary tabs.

Column Description
Payer Name of payer designated on the claim.
Adjustment Category Category of adjustment made.
Patient Control Nbr Unique number assigned by the facility or the patient.
Claim Adj. Group Code Code indicating category of adjustment made on the claim.
Claim Adj. Code Code indicating reason for claim adjustment.
Claim Adj. Information Description of claim adjustment.
Claim Adj. Amount Dollar amount by which adjustment was made.
Claim Adj. Qty Number of times claim was adjusted.
Payment Date Date payment was received.

This tab reports on remit adjustments that occurred at the service level. The adjustments are reported at the claim and service line level. Service level details allows for deep dive analysis from the summary tabs.

Column Description
Payer Name of payer designated on the claim.
Service Line Adj. Category Code indicating category of adjustment made on the service line.
Patient Control Nbr Unique number assigned by the facility or the patient.
Service Line Adj. Group Code Code indicating category of adjustment made on the service line.
Service Line Adj. Code Code indicating reason for service line adjustment.
Service Line Adj. Description Description of service line adjustment.
Service Line Adj. Amount Dollar amount by which adjustment was made.
Service Line Adj. Qty Number of times service line was adjusted.
SL Adj. Service Code Service code associated with the service line adjustment.
Service Line Modifier Code Modifier code associated with the service line adjustment.
Service Line Rev Code Rev code associated with the service line adjustment.
Payment Date Date payment was received.