Payer Reimbursement (REM)

Payer Reimbursement (REM) gives analytical insight into the number of payments and payment amount each Payer has reimbursed the provider. It also lists claims falling within payments each Payer has reimbursed the provider. Payment number is broken down per Payer.

Business Use

  • Track payments and amounts reimbursed.
  • Trend at a high-level where remittances are greatest.

Running the Report

To generate the Payer Reimbursement (REM) report:

  1. Click Run on the Payer Reimbursement (REM) report pod.
  2. Select the option of whether or not to include test claims.
  3. Select one or more CIDs from the values displayed.
  4. Use the calendar function to enter a Payment Date (Start).
  5. Use the calendar function to enter a Payment Date (End).
  6. Click Run Query.

Tab Views and Field Descriptions

See the following pages for details on these tabs:

This tab highlights the overall payments flowing in. For each payer, the payment volume and total amount will be displayed. The top 15 payers, ordered by total payment amount, will be displayed in a chart.

Field Description
Payer Name of payer designated on the claim.
Total Number of Payments Count of all payments each payer has sent.
Total Payment Amount Total value of all payments received from payer.

This tab provides claim-level detail for payments received.

Field Description
Payer Name of payer designated on the claim.
Payment Number Payment number from matched remittance.
Claim Form Type UB (Institutional) or 1500 (Professional).
Inpatient/Outpatient Denotes whether the claims are inpatient or outpatient.
Facility ID Facility ID within CID.
Primary/Secondary Primary or Secondary claim.
Patient Control Number Unique number assigned by the facility or the patient.
Payment Date Date payment was received.
Total Claim Payment Total value of payment made by payer.
Total Claim Amount Claim Amount – MSP Amount (MSP Amount reflects payment by a previous payer and will only be non-zero on a Secondary or Tertiary claim).
% of Charge Amount Total Claim Payment/Total Claim Amount.