Remittance Advice (RA) / Electronic Remittance Advice (ERA)
After the Fiscal Intermediary Standard System (FISS) completes processing your Medicare claim, either an RA (also known as a Standard Paper Remittance (SPR)), or an ERA (also known as an Electronic Remittance Notice (ERN)) is provided with final claim adjudication and payment information. It is recommended that providers accept ERA transmissions in lieu of mailed SPRs. The ERA contains all information found on the SPRs, as well as additional information not available on an SPR.
All ERAs are sent in the X12 835 version 4010A1 format or 5010. The free software, PCPrint, is available for providers to read and print the ERA. Instructions for PCPrint are included with the software download which is available on the PC Print Download Available web page.
CGS releases ERAs (835s) no later than 1:00 p.m. Eastern Time (ET) daily. The electronic remittance advice (ERA) file is available for download from a GPNet mailbox for 14 days. Once downloaded, that file is no longer available for download. However, if necessary, you may request the ERA to be made available in your mailbox by accessing the EDI Report Request Tool web page. The request must be made within 45 days of the remittance advice date. After 45 days, CGS will charge $15.00 for each remittance advice (electronic or paper) that you request. Requests for RAs/ERAs can be made by completing the Home Health & Hospice Duplicate Remittance Advice Request Form. We will not process requests for hard copy duplicates until after this 45 day period expires.
Duplicate Remittance Requests
Access the Home Health & Hospice Duplicate Remittance Advice Request Form to request a hard copy duplicate of a home health or hospice Medicare remittance advice (RA) (electronic or paper). There is a charge of $15.00 for each duplicate remittance advice (electronic or paper) requested. Requests will be completed within 45 business days of receipt and mailed to the remittance advice address on the Fiscal Intermediary Standard System (FISS) provider file.
- Understanding the Remittance Advice: A Guide for Medicare Providers, Physicians, Suppliers and Billers
- Medicare Claims Processing Manual (CMS Pub. 100-04, Ch. 22)
- Health Care Payment and Remittance Advice
- Overpayments Resulting From a Claims Adjustment - Medicare Financial Management Manual, CMS Pub. 100-06, Ch. 3, Section 40 – 40.1