সরবরাহকারী ম্যানুয়াল

SUMMARY VOUCHER/ELECTRONIC REMITTANCE ADVICE (ERA)

Providers are able to view a comprehensive list of claims that were either paid or denied via the summary voucher. The summary voucher includes information such as the member’s name, date of service, procedure code, units, total charges, paid amount, explanation of payment code, etc. The summary voucher is sorted alphabetically by the member’s last name and is systematically generated after each check run. Provider Summary Vouchers are available online at ProviderConnect (pa.carelon.com/providers). Providers can also access electronic PSVs and sign up for Electronic Funds Transfer (EFT) at Payspan Health (www.payspanhealth.com). Providers without a computer or access to the internet may obtain a faxed copy of a PSV by using an automated faxback service at 866-409-5958.

The voucher will be in ProviderConnect 24-48 hours after the check run and will be available on PaySpan immediately after the check run. Even if the provider is in a negative balance, the summary voucher will show all claims activity until that negative balance is satisfied. One voucher is generated per county; therefore a provider may receive multiple vouchers. The explanation of payment (EOP) code indicates the reason the claim was paid or denied.

Providers can obtain an 835 or an electronic remittance advice (ERA) file from PaySpan. The main difference between the ERA and summary voucher is that the ERA, unlike the summary voucher, will hold all claims detail until the negative balance for the provider is satisfied. Also, no “zero” payments or denials are reflected in the ERA. Only positive or negative payments are included. The ERA acts as a text file that may be programmed to upload into your practice management software. The ERA contains all of the same data elements as in the summary voucher. To request a copy of the ERA file layout, you may contact e-Support Services at 888-247-9311.

View a Sample Summary Voucher