What document is sent with payment detailing payments and adjustments made during adjudication?

The remittance advice is a crucial document in the medical billing process, as it provides a comprehensive summary of the payments that have been made by an insurance company or payer for services rendered. It details not only the payment amount but also any adjustments that have occurred during the adjudication process, such as denied claims, contractual adjustments, and patient responsibility amounts. This document serves as a communication tool between the payer and the healthcare provider, helping to clarify the financial aspects of the claim.

The clarity and detail provided in the remittance advice are essential for medical coders and billers to reconcile accounts, ensure accurate billing, and address any discrepancies promptly. The presence of detailed adjustments allows healthcare providers to understand how payments were calculated and to take necessary actions regarding unresolved claims.

While other documents like the Explanation of Benefits (EOB) serve similar purposes in the context of patient communications regarding their benefits and payments, the remittance advice specifically relates to the transaction details from the payer’s perspective, making it the correct answer to the question about the document sent with payment that details adjustments made during adjudication.