Edi Remittance Sample
- 1. EDI REMITTANCE PROCESSING Functional Overview October 2008 INFORMATION SERVICES
- 2. An automated scheduled mainframe PRE-POSTING JOB runs early in the morning that First FTPs and looks for the latest EDI file for the payor at a payor-specific location. If the EDI file is found, then the EDI file is downloaded onto the mainframe and a backup created as well Then PARSES the EDI file And then creates a Pre-Posting report in PRIMES for validation of the remittance posting amounts for the day or specific period The Patient Recon. Department approves the postings in PRIMES with a letter “P” An automated scheduled mainframe POSTING JOB (PAF25200) run for Payor Medicare at 2:00 pm that Posts payment amounts in PRIMES and updates the customer accounts Generates a remittance posting report in pdf format that is uploaded to a shared drive Automated scheduled mainframe POSTING JOBs for all other Payors are triggered by PAF25200 above, to accommodate secondary billing Posts payment amounts in PRIMES and updates the customer accounts Generates a post-posting report in pdf format that is uploaded to a shared drive Further, automated scheduled mainframe REMITTANCE POSTING JOBs are triggered by the above payor-specific POSTING JOBs to update the DENIALS database EDI Remittance Posting STRUCTURE OF A JCL JOB 1. JOB (PAF25110) 1.1 PROCEDURE (AF25110) 1.1.1 PROGRAM (IEFBR14) 1.1.2 PROGRAM (AFGP2016) EDI Payment Posting Process (THE HOW)
- 3. EDI Remittance Posting Workflow Diagram