Outpatient Facility Coding Alert - 2018 Issue 8
Remittance Advice: Keep CARC/RARC Current to Track Payment and Denials
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Article Overview
This article is a practical overview for billing and coding staff in a surgical practice who need to understand Medicare remittance advice and electronic remittance advice. It focuses on the role of standard claim adjustment and remark code sets, the importance of keeping those code lists current, and the use of remittance data to identify denial patterns, payment issues, and workflow areas that may need review.
Why This Topic Matters
Remittance advice is a routine source of information about payment and denial activity, and keeping related code references current helps staff interpret payer responses accurately. The article also shows why remittance review matters for tracking trends, improving claims accuracy, and supporting internal billing process review.
Article Sections
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Take a Bead on RAs
Introduces remittance advice and electronic remittance advice, explains their general role in claim follow-up, and distinguishes them from patient-facing explanation documents.
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Translate CARC/RARC
Reviews the need to interpret standard remittance code sets, locate current reference information, and stay aware of routine update cycles and code maintenance resources.
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Track Denials to Improve Claims Accuracy
Describes how practices can use remittance information to monitor denials, look for broad patterns in adjustments, and support internal review of billing and documentation processes.
What You Will Learn
- How remittance advice supports payment and denial review
- Where current standard remittance code references are maintained
- Why routine code updates matter for billing workflows
- How denial data can be used to look for broader practice trends
- What kinds of internal process areas may be reviewed after denial analysis
Who Should Read This
- Surgery practice billers
- Coding staff
- Revenue cycle staff
- Practice administrators
- Billing managers
Codes Discussed
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