Which statement best describes the purpose of remittance advice for post-claim processing?

• A. It documents how a claim was paid, adjusted, or denied and is used for posting and reconciliation.
• B. It lists upcoming eligibility requirements.
• C. It explains how to file new claims.
• D. It provides patient satisfaction metrics.

Answer: (A)

Remittance advice is the payer’s detailed notice of how a submitted claim was processed after payment. It shows the payment amount, any adjustments or write-offs, and any denial or reason codes. In post-claim processing, its main purpose is to guide posting to the patient’s account and to reconcile the payment with the billed charges, ensuring the accounting matches the payer’s records and flagging any discrepancies for follow-up. It also provides the basis for auditing the transaction and for potential appeals if needed. It does not provide upcoming eligibility requirements, instructions for filing new claims, or patient satisfaction metrics.