View Accounts with Remittance Advice Variance

Use this procedure to view accounts with remittance advice variance. Not all facilities have access to this page.

  1. To access the Remittance Advice Variance page, select Go To > Government Payor Research > Medicare > Remittance Advice Variance.
  2. Specify the criteria to narrow the search results and click Display RA Variance. The results appear. The columns displayed are slightly different for each patient type.

    When the Claim Status is All, denied claims are excluded from the totals only if the denied record is the most recent RA record received.

  3. To view additional details regarding the information on this page:
  4. Optionally, you can click a link in the:
    • Click a link in the Patient Number column to display the Patient Account Audit page. For more information, refer to View the Patient Account Audit Page .
    • Click a link in the R/A Date column to display the Remittance Advice Detail page for the account. For more information, refer to View Remittance Advice Details.
    • Click a link in the Billed DRG or Paid DRG columns to display the DRG Description page for the code (Acute/DRG patient type only).
    • Click a link in the Expected CMG or Paid CMG column to display the CMG Description page for the code (Rehab patient type only).
  5. To export RA variance information:
    1. Select either Microsoft Excel or Text File from the Export To list.
      • Select Microsoft Excel to open Excel. You can then work with the data in Excel; for example, to move or delete columns, re-sort or re-format the data.
      • Select Text File to save the data as plain text (with no formatting). Typically, you select this option if Excel is unavailable on your computer or you have Excel version’97 or older.
    2. Click Export.

The following table describes each of the fields on the Acute/DRG version of the Remittance Advice Variance page.

Field

Description

Billed DRG

Diagnosis Related Group for which the patient was billed

Charge Variance

Covered charges paid minus covered charges billed

Claim Status

Status of the Claim. Options include:

  • All
  • Processed as Primary/Reversal of Previous Payment
  • Denied - at least one record for this patient was denied by the payor.

Contractual Variance

Paid contractual minus expected contractual

Covered Charges Billed

Billed charges minus non-covered charges

Covered Charges Paid

Amount Medicare accepts for payment

Discharge Date

Date patient was discharged; defaults to the current system date. If you enter a specific discharge date, the results are displayed for the closest date available (from data within the system).

End Date

Last date in the date range

Expected Contractual

Covered charges billed minus expected payment

No.

Sequential number of the account in the current set of accounts, based on the sort method

Paid Contractual

Amount already paid by Medicare

Paid DRG

Diagnosis Related Group for which Medicare paid

Patient Number

Patient account number (for UB claims) or insured ID (for CMS-1500 claims)

Patient Type

Patient type assigned to the account

Options include Acute/DRG, SNF, Rehab, Psych Per Diem, Psych PPS, Outpatient, Pediatric IP, Pediatric OP, Managed Care, Medicaid, Medicare IP Part B

Payor Code(s)

Payor code associated with the product

FL56

R/A Date

Date the remittance advice report was created

Reim. Variance

Variance amount and type: Variance, Underpayment, Overpayment, Paid Correctly

Reim. Variance

Reimbursement variance—charge variance minus contractual variance

Show

Indication of what is being displayed: R/A Variances, R/As with no accounts, Accounts with no R/As

Sort By

How the results are sorted

Start Date

Start of a date range.