Reconcile Claims & Patient Accounts with Provider Connect

Beginning May 1, providers who log into Provider Connect will be able to look up a remittance and view all of the claims included in the payment, whether they are set up for electronic remittance advice (ERA) or paper remittance advice (PRA).

The online remittance feature will support provider offices in their efforts to reconcile claims and patient accounts. Provider Connect users can look up a remittance by date and line of business or using a link from a specific claim. The online remittance will also display any claim refunds that reduced the amount of the payment – information currently provided via separate notice.

Other Enhancements

The Claim Detail Summary has been enhanced to include the member’s Plan ID and Patient Account number to help provider offices more easily link the claim to the patient. The status is displayed in red text so that it stands out to the viewer.

The Claim Line Item Details for completed medical claims now include more details about how the payment amount was calculated and provides patient responsibility details. The additional information will allow providers to better manage their patient accounts and communicate with Plan members about their responsibility for payment.

Additional details are also provided regarding claim amounts that have been disallowed to provide 24/7 access to information needed regarding claim determinations made by the Health Plans.

Feedback regarding the changes to Provider Connect is welcome and necessary for Samaritan Health Plans to continue to improve and expand the 24/7 self-service features available. Please contact us with your comments.

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