The paper Remittance Advice (RA) is issued weekly to participating or in-network providers who submit claims on paper. It is designed to help providers identify their patients' processed claims and includes those that are paid, denied or adjusted.

We send a separate Remittance Advice and payment check for each of the following benefit programs:

• Federal Employee Program (FEP)

• Host Regional (NEHP)

• Indemnity

• Medicare Supplemental Program (Medicomp)

• The Vermont Health Plan (TVHP)

• Vermont Health Partnership (VHP)

If adjustments or recoveries create a negative balance, we mail a negative balance report instead of the RA.

Understanding your RA - Summary Page

1. For Payment Date—the date the RA and payment are issued
2. Professional Remittance—services were billed on a
   HCFA 1500 form
3. NPI—the group NPI number for which the RA is being issued
4. Check Number—the number of the check issued for this RA
5. Check Amount—the amount of the check issued for this RA
6. Group name and mailing address that matches the provider number

Understanding your RA - Detail Pages

1. Group name and mailing address
2. NPI—the group NPI number for which the RA is issued
3. Benefit program that claims processed under
4. For Payment Date—the date the RA and payment are issued
5. Date of Service—the date of service processed
6. PS—the place of service
7. TS—the type of service which is applied by the BCBSVT andTVHP claim processing system
8. Proc. Code—the CPT or HCPC code being processed
9. Total Charge—the total charge submitted by the provider for the service rendered
10. Non-Allowed Amount—the dollar amount the provider must write off
11. Deductible Amount—the dollar amount applied to the patient’s deductible
12. Other Ins.—the dollar amount paid by another carrier
13. Basic Payment
14. Co-Ins Amount—the dollar amount applied to the patient’s coinsurance
15. Co-Pay Amount—the dollar amount applied to the patient’s co-payment
16. With Hold—the dollar amount applied to provider’s withhold fund
17. Payment Amount—the dollar amount to provider is being paid for the services
18. Contr Allay—the dollar amount to be taken for a contractual reduction
19. Due from Patient—the total dollar amount due from patient: this combines the Deductible, Co-Ins, Co-pay and non-covered charges the patient must pay.
20. Cert #—the ID number the claim is processed under
21. Patient Name—the patient’s last and first name
22. Pat Acct#—the practice assigned patient number
23. Claim #—the claim number applied by the BCBSVT and TVHP claim processing system
24. Claim Total—the total dollar amount for the claim
25. Provider Total—the summary of total processing of the claim