The remittance voucher displays the disposition of all claims processed during the claims cycle. A remittance voucher is mailed each week if the fiscal agent processed any claims or put any claims in “Suspend” status. If the provider receives payment by paper check, the check is mailed separately.
Role of the Remittance Voucher
The remittance voucher plays an important role in communications between the provider and Medicaid. It tells what happened to the claims submitted for payment–whether they were paid, suspended, or denied. It provides a record of transactions and assists the provider in resolving errors so that denied claims can be resubmitted.
The provider must reconcile the remittance voucher with the claim in order to determine if correct payment was received.
The remittance voucher contains one or more of the following sections, depending on the type of claims filed, the disposition of those claims, and any new billing or policy announcements:
· Remittance Voucher Banner Page Message
· Disposition Category by Groups
· Summary Section
Remittance Voucher Banner Page Message
When Medicaid or the fiscal agent discovers billing problems encountered by all or selected provider types, a remittance voucher banner message is printed as the first page of the voucher. Suggestions for avoiding problems, explanations of policy, and new or changed procedure codes are described. Training sessions
are also announced on the remittance voucher banner page.
Disposition Category by Groups
Claims are listed by disposition category (paid, denied, or suspended) in alphabetical order by the recipient’s last name. Voids and adjustments are also listed separately.
All claims in the “Suspend” status are reported each week until adjudicated as “Paid” or “Denied.” If one line on a claim form suspends, then the entire claim will suspend until all of the claim lines can be adjudicated.
The remittance voucher summary section reports the number of claim transactions, and the total payment or check amount. If the account shows a prior negative balance, it will be carried forward weekly until eliminated.