Out of Balance Electronic Remittance Advices will Become Available on October 6, 2008

Beginning, October 6, 2008, CEDI will begin returning Out of Balance (OOB) Electronic Remittance Advices (ERAs) to all electronic trading partners when an OOB ERA is created by a DME MAC.

In the past, OOB ERAs were not returned to electronic trading partners. Due to the many requests from DME MAC suppliers and software vendors to receive this information, the OOB ERA’s will be returned beginning October 6, 2008.

OOB ERAs are normally created when Medicare Secondary Payer (MSP) claims exists in the file and the reason and remark code on the ERA was valid when the claim was paid, but is no longer valid when the ERA is created. OOB ERAs are seldom created and will not balance with the amounts paid and adjusted.

CEDI has notified software vendors of this change and worked closely with them to determine the best method of returning this information.

On October 6, 2008, Electronic trading partners can determine when an OOB ERA is created by the naming convention of the ERA file. An OOB ERA will begin with “OOB835” in the file name. When an OOB ERA file is received, please contact your software vendor to determine how to view and post the file correctly.

Post Date 09/08/08