AANEM News Express

AANEM News Express

Denials? AMA's Tool Could Help

8/26/2014
 
Does your practice utilize Electronic Remittance Advice (ERA)? If so, the American Medical Association (AMA) recently updated an online tool, called the Claims Workflow Assistant, which can help your practice ensure accurate payment of claims and appeal denials.
 
ERA is a transaction that provides an electronic version of an explanation of payment and contains detailed information regarding a provider’s adjudicated claim. Claims Adjustment Group Codes (CAGC), Claims Adjustment Reason Codes (CARC), and Remittance Advice Remark Codes (RARC) are used together on the ERA to give providers an array of information regarding their claims. However, a practice needs to fully understand the meanings of these codes and take appropriate actions in order to appreciate the positive aspects of the electronic claims processing system.  The Claims Workflow Assistant can help you look up codes used in ERA transactions, understand what each code means, and recommend step-by-step workflows for addressing claim denials and non-payment.


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