The Remittance Page

One remittance in full: what the payer said, what it did to the balances, and the corrections available. Remittances is where you find it.

Who Can See It

User, when the client is licensed for remittances. Post Reversal, Supersede, Post Manual Adjustment and Rebill to Another Payer also need Manager or Administrator. Without one, the three card actions are missing and Rebill to Another Payer is greyed.

The Header

The remittance’s identifier comes first: its check number, or the trace number or ICN when the payer sent no check number. Beside it sit the posting status, then Secondary or Tertiary when the remittance belongs to a secondary or tertiary claim, then the payer’s claim status, then a findings count when the rules found errors or warnings; selecting the count opens the Findings tab. At most three fit, so Secondary or Tertiary gives way when the claim status and the findings count are both shown. The line beneath names the payer, links the claim, and gives the patient and the amount paid.

The Tabs

Tab	What it holds
Overview	The remittance, the claim it matched, the money, and the service lines
Findings	What the remittance rules found, counted in the tab. A finding on a field you edited reads Edited · checked again when you release
Activity	Notes, the decision taken on it, and the work queue items it has been through. See Record Activity

A note pinned to the remittance shows as a banner above the header, on every tab.

What Overview Carries

The cards sit in this order, in as many columns as the screen fits.

Card	Fields
Remittance	Payer, Payer ID, Payment Method, Payee, Payee NPI, Check/Trace #, Paid To, Payment Date, Received by Practice, Payer Received Claim, Patient on the 835
Amounts	Billed, Adjustments, Patient Resp., Paid, Unexplained
Check	The check or EFT this remittance came on. See The Check Card
Resolution	Resolution, Notes, Decided
Claim	Claim, Patient, ICN, Status
Adjustments	One row per adjustment: group, reason, remarks, amount. A PR row has a Dispute box for an amount the payer should take back

Where the 835 omitted a field, the page says what it substituted - for example using the claim’s insurance plan.

Received by Practice is the day the remittance reached you. It is filled in when the 835 is imported, and you can correct it while the remittance is held, for example for an old 835 imported late, but not leave it blank. Reports date the remittance by it. Payer Received Claim comes from the 835 and is the day the payer logged the claim, usually weeks earlier.

The Check Card

The Check card shows only when the 835 sent a check amount or a provider-level adjustment.

Row	What it shows
First line	The trace number and how many claims are on this check, counting a claim the payer paid nothing on
Claim payments	What the payer paid across every claim on the check
One row per provider adjustment	The reason code (hover for its name), the reason, the payer’s reference, and the effect on the check: a recoupment such as Overpayment Recovery shows as a minus, interest the payer owes as a plus
Under a recoupment	What happened to it: Recouped from or Already taken back on the claim it names, linked. A warning when no claim matches its reference (nothing was posted) or when you had already refunded the same money to the payer
Check Amount (BPR02)	The total the payer sent. Missing when the 835 gave none
Tie-out	A check mark when claim payments less the provider adjustments equal the check amount, otherwise Off by and the difference. Missing when the 835 gave no check amount

Service Lines

Service Lines run full width beneath the cards, in fourteen columns: one row per line the payer returned, then each claim line the payer did not answer, muted, with Not on this remittance in Codes, or Answered at claim level when the payer answered the whole claim at once. A returned line that is not on the claim shows Not Billed on This Claim.

Column	What it shows
#	Line number
Serv Date	The date of service
POS	Place of service
Units	Units paid. Where the payer paid fewer than were billed, the row reads, for example, 1 of 2, and hovering it says how many were billed and paid
Proc	The procedure billed. Where the payer adjudicated a different code, the row shows the billed code and then the paid one
Mods	The modifiers billed. Where the payer returned different ones, the row shows both sets
Billed	What was charged for the line
Allowed	What the payer allowed. A dash means the payer has pended the line (hover reads Pending payer review), or denied it and paid nothing. Where the payer’s figure differs from billed less the contractual adjustments, that derived figure shows beneath
Adjusted	The net of every adjustment on the line. When there is more than one, hover for each code and its amount
Deduct	The patient’s deductible on the line, or a dash when there is none
Copay	The patient’s copay on the line, or a dash. Deduct, Copay and Coins are separate cost-share columns, and a line can carry more than one
Coins	The patient’s coinsurance on the line, or a dash
Prov Pd	What the payer paid the provider for the line
Codes	The line’s adjustment reason codes, then the remark codes the payer sent with them

Posting Status

Status	What it means
Held	Nothing has posted. A review item is holding it
Posted	The entries are on the ledger
Reversed	The posting was backed out; the ledger is closed to new adjustments
Superseded	Closed without ever posting, because a corrected remittance replaced it
Returned to Payer	Closed without ever posting, because the money was not the practice’s. The import stub it matched was voided
Overturned	A posted denial whose appeal the payer later paid. Its denial codes stay on record, and the paying remittance carries the money

Resolutions

A held remittance needs a resolution before its review item can close. The Resolution card offers these, in this order.

Resolution	What it means	When it is greyed or refused
Reverse Charges	Void the claim this remittance answers and reverse its charges, so it nets to zero. The payer isn’t told	Refused while the remittance pays anything: This remittance pays the claim. Post it, then reverse or refund the payment.
Write Off	Post it and write off what the payer still owes. Only the insurance balance is written off; the patient’s share stays with the patient	Refused when posting leaves a credit to the payer, which a write-off cannot settle; choose Refund to Payer instead
Accept	Take the payer’s answer as given. On a denial, the denied amount stays owed by the payer until you write it off, appeal it or bill the next payer	-
Bill Patient	Post it and move what the payer still owes to the patient’s balance	Greyed when posting leaves nothing owed by the payer to move to the patient
Post as Overturn	Offered when the remittance pays a claim whose earlier denial you appealed. Post it, mark that denial Overturned and record the appeal as won	Greyed on any other remittance
Refile	Post it and generate a replacement claim for the payer	-
Rebill to Another Payer	Post it, void the claim in ClaimPod with its charges reversed, and raise a new claim from the visit to the coverage you pick in Bill To	Greyed without Manager or Administrator, and while the remittance pays the claim (This remittance pays the claim, so it can't be rebilled.)
Appeal Denial	Post it and record an appeal. Appeal By starts two weeks before the payer’s appeal deadline, and its hint names the deadline, such as Payer's window closes 11/02/2026, 14 days later.	-
Dispute With Payer	Offered once a PR row is marked Dispute. Post it and bill the patient their share, but keep the disputed amount owed by the payer, so statements skip it. On the Check Back On date the claim returns to Follow-up Claims	Greyed until a PR row is marked Dispute; while one is, every other resolution is greyed
Combined Into Another Claim	For a denial the practice caused by billing the same work twice, such as a second same-day visit folded into the other physician’s claim. Close this claim because its work is billed on the claim named in Combined Into. The preview shows each denied amount as Claim Combined with its code, while a contractual write-down such as CO-45 stays contractual, and Combine Claim confirms. The denial is then not counted against the payer in Payer Scorecard or Denial Analysis, and both claims’ Resolutions tabs link to each other	The target must be another open claim of the same patient, found by claim number or patient. It cannot be voided, closed, an import stub, or itself combined into another claim, and this is checked again when the review completes
Not Ours - Return to Payer	For money that landed on an import stub but belongs to no claim of the practice. Close this remittance without posting and reverse the stub’s charge; the practice owes the payer a refund, issued outside ClaimPod. The preview reads Nothing posts and shows the posting moving from Held to Returned to Payer, and Return to Payer confirms. When several remittances are held on the same stub, return each one; the stub’s charge reverses with the last	Greyed on any claim that is not an import stub. Fails once another remittance on the stub has posted
Refund to Payer	Post it, then record the money going back to the payer, so the claim ends at $0.00. Asks for Method (Check unless you change it) and Check / EFT #, and the preview adds the refund row	-

A Remittance Review item also offers Records Sent: post the remittance, record the records you sent and check back on the Response Due date. Once chosen there, the card shows Records and Response Due.

A denial never takes money off the claim by itself. Its adjustment codes are recorded, but the denied amount stays on the claim, owed by the payer, until a resolution decides it: Write Off posts a write-off, Bill Patient moves it to the patient, Rebill to Another Payer reverses the charge, and Accept, Appeal Denial and Refile keep it owed. When the next payer should pay as well, for example on CO-119 (benefit maximum reached), use Bill Secondary on the claim. When the claim went to the wrong payer, as on CO-22 (covered by another payer), use Rebill to Another Payer.

An appeal stays Open until the payer answers. A payment on the appealed claim waits with the finding Appeal Overturned; Post as Overturn records the appeal Won and marks the denial Overturned. A repeated denial shows Appeal Upheld, and Write Off, Appeal Denial, Refile or Rebill to Another Payer records the appeal Lost, as does closing the claim from its follow-up. The claim’s Resolutions tab shows each outcome.

A secondary payer’s remittance that arrives before ClaimPod has a secondary claim for it is held as Secondary ERA, so its money never posts on the primary claim. Use Bill Secondary on the primary claim: it creates the secondary claim and moves the held remittance onto it, where it posts. The payer already has that claim, so it is marked Submitted by crossover and Export 837P never sends it again. A tertiary payer’s remittance waits on the secondary claim the same way until Bill Tertiary.

Beside the resolution, a preview lists what will post. When the patient has another coverage on file, the patient responsibility previews as a Payer Transfer onto a secondary claim, with a balance row for that payer’s secondary claim, rather than as a balance to the patient. A denied amount previews as a note that it stays owed by the payer, not as a ledger row; Write Off adds the write-off row that would settle it. A denial with nothing else to post reads Nothing will post - a denial records its codes without moving the balance.

Actions

Action	What it does	Where it appears	When it is greyed
Recheck	Runs the remittance rules again. If it fails, a toast says Couldn't recheck the remittance	Page header	While a check is running
View Raw EDI	Opens a side sheet with the 835 exactly as received, one segment per line, and Copy	Page header, only when the raw EDI was stored	-
Reassociate Claim	Moves it to a different claim, found by searching claim number or patient, after a confirmation	The Claim card’s menu. Not offered on a superseded or returned remittance	-
Post Manual Adjustment	Adds an adjustment entry	The Adjustments card’s menu, once the remittance is no longer held. Missing on a superseded or returned remittance, and without Manager or Administrator	Once reversed - the ledger is closed to new adjustments
Add Adjustment	Adds a row while editing	The Adjustments card’s menu, while the remittance is held	-
Post Reversal	Backs the posting out. When that payment had been billed on to a secondary claim, a secondary still in draft or ready is voided, and one already filed raises a Secondary Unwinds item	The Amounts card’s menu. Missing once the remittance is reversed, superseded or returned to the payer, and without Manager or Administrator	While the remittance is held: A posting to reverse - this remittance hasn't posted.
Supersede	Closes a held remittance without posting it	The Amounts card’s menu, only while the remittance is held. Missing without Manager or Administrator	-

Reassociate Claim is refused when the target is the claim it is already on, and on a posted payer takeback, whose entries offset an adjudication on the current claim. A takeback releases only when its amount mirrors one posted adjudication on the claim; otherwise it stays held with a danger finding that starts This takeback was not posted:, and the remittance it would reverse keeps reading Posted.

Supersede is for the payer sending the same remittance twice, corrected. It asks first, listing every line that will never post and confirming the claim balance stays where it is. Post the corrected remittance before closing this one: Close Without Posting cannot be undone, and Keep Held backs out.

Edits save through a save bar, and leaving with unsaved work asks first. If someone else saved the remittance or its resolution first, including a first decision recorded while you were deciding, the bar shows Reload in place of Save Changes. Reload drops your edits and loads the decision on record; see A Save Was Refused.

States

• Held - nothing posts until the review item is resolved. Saving a decision here says Resolve the item in Remittance Review to release the posting.
• Never filed - a remittance for a claim that was never filed from ClaimPod is held with a finding that says to export the claim, then Recheck this remittance.
• Posted - hover the posting badge for the date it posted, and the note that corrections post new entries rather than editing old ones. On a superseded remittance the badge explains that a corrected sibling carries the money.
• Nothing to post when the remittance carries no payment and no adjustments.
• Superseded replaces the posting badge, and no posting action is offered again.
• Returned to Payer replaces the posting badge the same way; hover it for the reminder that the refund is issued outside ClaimPod.
• Blocked - without the remittances module the screen is not in the sidebar, and a saved link to it says the module is not part of your plan.

Related: Remittances · Work a Remittance Review Item · Post an Adjustment or Reversal · Payments Look Wrong