IF YOU RECEIVE YOUR MEDICARE REMITTANCE ADVICE electronically, then RAPrint is the perfect solution for printing the information contained in the remit file. In developing RAPrint, we sought to find a solution that would meet the needs for Medicare Cost Reporting, secondary payers, and most importantly, the person in the Business Office that has to use this data day in and day out. We wanted this program to be effective, efficient, and simple to use. We haven’t reached perfection yet, but we believe RAPrint is well in front of the rest of the field.


SEARCH OPTIONS

RAPrint allows you to search for an individual EOMB using one of four (4) different criteria:

1. By the hospital patient account (control) number (PCN).

2. Using the Patient’s last name.

3. By the patient’s Medicare number (HIC #)

4. By the patient’s medical record number (MRN)

The search displays the EOMB and gives you the option of printing it on your default print or of continuing to search for additional records based upon your search criteria.


REPORT FORMATS

There are two basic report formats:

The ALL CLAIMS format is similar to the old Medicare paper remittance.
(VIEW | DOWNLOAD)

The EOMB FORMAT allows you to print just one EOB per page.
(VIEW | DOWNLOAD)

You have the option to print “full detail” or “no detail”. No detail will save significant time and paper, because it suspends printing of service level detail.

REPORT OPTIONS

RAPrint provides you with the following report options:

1. All Claims Report
Prints the data for all the claims withing a claim type, followed by the summary report. Virtually all pertinent data found in the file is reported.

2. All Claims by Date
At the end of your fiscal year it is sometimes necessary to know the claims and amounts incurred either before or after a cut-off date. This option asks you for a cut-off date and if you want claims before or after that date. The claims are then printed and totaled in the same format as the All Claims Report.

3. Claim Summaries
Prints the summary information as found in the file for a claim type or types, either by summing the individual claims or by the intermediary provided totals in the 835 file.

4. Denied Claims Report
Prints only those claims that were denied. The criteria for selecting denied claims is any value other than $0.00 in the denied claim field on the claim level or service level or that the Claim Status code is a 4 and is not a reversal (type 22). You may choose those claims with a status code of 4 (entire claim denied) or those claims with only a denied amount or service.

5. Non-covered Claims Report
You may select either claims with non-covered charges or claims with non-covered days.

6. Negative Claim Report
Prints those claims that have a Claim Payment amount less than $0.00.

7. Replacement/Reversal Claims Report
Prints those claims that were reversed and/or replaced. Claims may be printed in the ALL CLAIMS format (multiple claims per page) or in the EOMB format (one claim per page).

8. Provider Totals Report
Prints a summary of the number of claims by type and the reimbursement amount. Adjustment codes and amounts are printed and the net reimbursement for the Remittance Advice is shown.

9. Case Mix Report
A report showing the average DRG weight by fiscal year of the claims contained in this Remittance Advice.

10. Outlier Claims Report
Selects and prints only those claims that have outlier amounts. The outlier may be ‘day,’ ‘cost,’ ‘capital’ or ‘operational.’ When shown in the ALL CLAIMS format, all outlier is summed and shown under the heading of Outlier Amt with the exception of Capital Outlier amount which is shown as a separate item.

11. Cross-Over Claims Report
Selects those claims with a claim status code of 19, 20, 21, or 23, and also is not a replacement claim (frequency code of 7).

12. Non Cross-Over Claims Report
Prints those Medicare claims that did not automatically cross over to Blue Cross, Medicaid or other third-party payor. This allows you to print only those EOMBs which must be reviewed for secondary insurance and filed via paper claim.

To order RAPrint, complete the license/order form and mail along with your check to:

AP Associates
504 Woodfield Drive
Asheville NC 28803

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Download the AP Associates software summaries in printable PDF format.