Which file is used to enable remittance code mapping at the plan, payer, or service area level?

Study for the RHB330 Resolute Hospital Billing Claim and Remittance Test with questions, hints, and explanations. Enhance your billing skills and excel in your exam!

Multiple Choice

Which file is used to enable remittance code mapping at the plan, payer, or service area level?

Remittance code mapping relies on a translation file that tells the system how payer remittance codes correspond to your internal posting codes across different plans, payers, or service areas. This mapping is supplied as a flat file from your bank, and you import it so the system can apply the correct translations when payments are posted. The bank’s flat file contains the exact code mappings the system needs, making it the source of truth for this setup. EDI files from insurers carry actual remittance data (the 835), not the translation rules; a payer CSV isn’t the standard mapping format used by the system; and while a bank-related flat file serves the same purpose, the specific source referenced for enabling the mapping is the flat file from your bank.

Remittance code mapping relies on a translation file that tells the system how payer remittance codes correspond to your internal posting codes across different plans, payers, or service areas. This mapping is supplied as a flat file from your bank, and you import it so the system can apply the correct translations when payments are posted. The bank’s flat file contains the exact code mappings the system needs, making it the source of truth for this setup.

EDI files from insurers carry actual remittance data (the 835), not the translation rules; a payer CSV isn’t the standard mapping format used by the system; and while a bank-related flat file serves the same purpose, the specific source referenced for enabling the mapping is the flat file from your bank.

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