Portal User Manual – Remittance Advice and Payment Offset Searches
Portal User Manual – Remittance Advice and Payment Offset Searches
You currently have jurisdiction selected, however this page only applies to these jurisdiction(s): .
Print the complete Portal User Manual
Providers can use the portal to view and print most regular remittance advices. To be available in the portal, the remittance advices must be:
- Issued within the past 13 months
- Not be larger than 150 pages
- Not be for an incentive or bonus payment
NOTE: The portal provides full remittance advices only. You cannot use the portal to obtain a remittance advice for a single claim.
Locating a Remittance Advice Using the Remittance Advice Search
You can access the Remittance Advice function by selecting the Remittance Advice link under the Claims heading in the left navigation menu. (If you do not see the Remittance Advice link, click the arrow next to the Claims heading to open the Claims menu.)
Step 1: Open the Remittance Advice Search and select your service location (NPI) from the dropdown list near the top of the page. If you only have access to one service location, the portal will automatically select it for you.
Step 2: Select your search criteria.
- To view all remittance advices issued within the last 30 days, check the box next to “Remits for the last 30 days.”
- To search for a specific remittance advice or one issued more than 30 days in the past, narrow your search using one of these options:
- Remittance advice date
- Remittance advice date range
- Part A remittance number
- Check/EFT number
- ICN/DCN
- Beneficiary and claim information (i.e., patient’s Medicare number, first initial and last name, and start/end dates of service)
Step 3: Click the Search Remits button at the bottom of the page to locate the remittance advice(s) that meet the criteria you entered.
Step 4: The portal will display any remittance advices that meet your search criteria. For each remittance advice, it will also display the region (i.e., jurisdiction and Part A/Part B), check/EFT number, check amount, remittance advice number (Part A only), and remittance advice date.
From the Remits Actions page, you can:
- Choose the View Remit link under the actions heading to view a copy of the remittance advice. To view a remittance advice, your browser must allow pop-ups from www.wpsgha.com. If your browser blocks pop-ups, right-click on the View Remit link and select “Open Link in New Tab (or Window)” or “Open in New Browser.”
- Select the Refine Search button to refine the current search or the New Search button to start a new search.
- Use the Show Entries dropdown box to change the number of rows viewable on-screen.
- Use the Filter box to filter the results.
- Use the arrows next to the column headings to sort the fields.
Locating a Remittance Advice Using Claim Inquiry
You can use the Claim Inquiry function to view and print the remittance advice issued for a specific claim. Please note that any remittance advice retrieved through the Claim Inquiry function will be the full remittance advice and will contain the same information as the original remittance advice. The portal does not provide remittance advices for individual claims.
Step 1: Locate the claim using the Claim Inquiry function.
Step 2: On the Claim Results page, click on the claim number to open the claim details.
Step 3: In the Claim Actions section, click Download Remit to open a PDF version of the original remittance advice in a separate browser tab or window. (If your browser blocks pop-ups, right-click on the Download Remit button and select “Open Link in New Tab (or Window)” or “Open in New Browser.”)
If the button is labeled “No Remit Available” instead of “Download Remit,” you cannot download a remittance advice. In most cases, this indicates the claim has not yet finalized or the remittance advice is too large to be displayed.
Locating an Offset Using the Remittance Advice Search
An offset occurs when Medicare recoups an overpayment by withholding payment from a future remittance. Providers can request an immediate offset when learning of an overpayment, or Medicare can initiate an offset if a provider does not refund payment by the due date.
On a Medicare Part B remittance advice, an offset is shown near the end of the remittance advice and can be identified with the PLB reason code “WO.”
You can use the Remittance Advice Search function to identify most Medicare Part B claims Medicare is recouping, as long as the FCN is 15 digits in length. The Remittance Advice Search function cannot be used to find claims if the FCN ends with the letters “AG.” (These are aggregated offsets involving multiple claims. Contact Payment Recovery for information.)
To determine which claim Medicare is recouping, locate the 15-digit FCN on the remittance advice containing the offset.
Step 1: Drop the first two digits of the FCN. The resulting 13-digit number is the ICN (claim number) of the adjusted claim that resulted in the overpayment. (For example, if the FCN is 221321140999999, remove the first two digits (22). The remaining 13-digit number, 1321140999999, is the ICN of the adjusted claim.)
Step 2: On the Remittance Advice Search page, enter the 13-digit ICN in the ICN/DCN field and click the Search Remits button at the bottom of the page.
Step 3: If the ICN is valid and processed within the previous 13 months, the portal will provide a link to the remittance advice containing the adjusted claim. Click the View Remit link to open the remittance advice. (If your browser blocks pop-ups, right-click on the Download Remit button and select “Open Link in New Tab (or Window)” or “Open in New Browser.”)
NOTE: Medicare offsets payments based on the EIN/TIN, not the NPI or PTAN. If your organization has multiple NPIs associated with the same EIN/TIN, Medicare may collect the debt under any NPI associated with the EIN/TIN. You must have access to the NPI (service location) the adjusted claim was processed under to view the remittance advice in the portal.
Step 4: Locate the ICN on the remittance advice. You can use Ctrl+F to open a search box to help you find the ICN on document. The remittance advice provides the claim details including the patient’s name, the date of service, and an explanation of how the claim processed. If you need more information about the claim, you can use the Claim Inquiry function to locate the claim shown on the remittance advice.
global-tags: J8A,J5A,J8B,J5B
.
View AMA License
LICENSE FOR USE OF PHYSICIANS' CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION (CPT)
End User Point and Click Agreement:
CPT codes, descriptions and other data only are copyright 2022 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA).
You, your employees and agents are authorized to use CPT only as contained in the following authorized materials of Centers for Medicare and Medicaid Services (CMS) internally within your organization within the United States for the sole use by yourself, employees and agents. Use is limited to use in Medicare, Medicaid or other programs administered by CMS. You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement.
Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60654. Applications are available at the AMA Web site, http://www.ama-assn.org/go/cpt.
Applicable FARS\DFARS Restrictions Apply to Government Use. This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60654. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (November 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.
AMA Disclaimer of Warranties and Liabilities.
CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. No fee schedules, basic unit, relative values or related listings are included in CPT. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this file/product is with CMS and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This agreement will terminate upon notice if you violate its terms. The AMA is a third party beneficiary to this agreement.
CMS Disclaimer
The scope of this license is determined by the AMA, the copyright holder. Any questions pertaining to the license or use of the CPT should be addressed to the AMA. End Users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.
Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by clicking above on the button labeled "Accept".
LICENSE FOR USE OF CURRENT DENTAL TERMINOLOGY (CDT™)
These materials contain Current Dental Terminology (CDTTM), Copyright © 2010 American Dental Association (ADA). All rights reserved. CDT is a trademark of the ADA.
THE LICENSE GRANTED HEREIN IS EXPRESSLY CONDITIONED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THIS AGREEMENT. BY CLICKING ABOVE ON THE BUTTON LABELED "ACCEPT", YOU HEREBY ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD AND AGREED TO ALL TERMS AND CONDITIONS SET FORTH IN THIS AGREEMENT.
IF YOU DO NOT AGREE WITH ALL TERMS AND CONDITIONS SET FORTH HEREIN, CLICK BELOW ON THE BUTTON LABELED "DO NOT ACCEPT" AND EXIT FROM THIS COMPUTER SCREEN.
IF YOU ARE ACTING ON BEHALF OF AN ORGANIZATION, YOU REPRESENT THAT YOU ARE AUTHORIZED TO ACT ON BEHALF OF SUCH ORGANIZATION AND THAT YOUR ACCEPTANCE OF THE TERMS OF THIS AGREEMENT CREATES A LEGALLY ENFORCEABLE OBLIGATION OF THE ORGANIZATION. AS USED HEREIN, "YOU" AND "YOUR" REFER TO YOU AND ANY ORGANIZATION ON BEHALF OF WHICH YOU ARE ACTING.
- Subject to the terms and conditions contained in this Agreement, you, your employees and agents are authorized to use CDT only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Use of CDT is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials.
- Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT. License to use CDT for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. Applications are available at the American Dental Association web site, http://www.ADA.org/.
- Applicable Federal Acquisition Regulation Clauses (FARS)\Department of restrictions apply to Government Use. Please click here to see all U.S. Government Rights Provisions.
- ADA DISCLAIMER OF WARRANTIES AND LIABILITIES. CDT IS PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND, EITHER EXPRESSED OR IMPLIED, INCLUDING BUT NOT LIMITED TO, THE IMPLIED WARRANTIES O F MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. NO FEE SCHEDULES, BASIC UNIT, RELATIVE VALUES OR RELATED LISTINGS ARE INCLUDED IN CDT. THE ADA DOES NOT DIRECTLY OR INDIRECTLY PRACTICE MEDICINE OR DISPENSE DENTAL SERVICES. THE SOLE RESPONSIBILITY FOR THE SOFTWARE, INCLUDING ANY CDT AND OTHER CONTENT CONTAINED THEREIN, IS WITH (INSERT NAME OF APPLICABLE ENTITY) OR THE CMS; AND NO ENDORSEMENT BY THE ADA IS INTENDED OR IMPLIED. THE ADA EXPRESSLY DISCLAIMS RESPONSIBILITY FOR ANY CONSEQUENCES OR LIABILITY ATTRIBUTABLE TO OR RELATED TO ANY USE, NON-USE, OR INTERPRETATION OF INFORMATION CONTAINED OR NOT CONTAINED IN THIS FILE/PRODUCT. This Agreement will terminate upon notice to you if you violate the terms of this Agreement. The ADA is a third party beneficiary to this Agreement.
- CMS DISCLAIMER. The scope of this license is determined by the ADA, the copyright holder. Any questions pertaining to the license or use of the CDT should be addressed to the ADA. End Users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CDT. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL COVERED BY THIS LICENSE. IN NO EVENT SHALL CMS BE LIABLE FOR DIRECT, INDIRECT, SPECIAL, INCIDENTAL, OR CONSEQUENTIAL DAMAGES ARISING OUT OF THE USE OF SUCH INFORMATION OR MATERIAL.