Remittance Report Sample  


The Claim Remittance Report is HIPAA 835 Response information translated to paper report form. This report is one of two remittance format options available to you. The other format is the Remittance Posting Report. See example of the Claim Remittance Report in Figure 1.

Note - Each payer has a unique protocol for the data they use or don't use with regard to remittance information. For this reason, the report display may vary slightly depending upon which payer the report is coming from.

 

 

Figure 1