A Provider Remittance Advice (PRA) is a summary of reimbursements made on all claims submitted. This statement is also called an explanation of benefits (EOB) when sent to members.
A PRA is:
- Issued for each unique provider number for which a claim was reimbursed.
- Included with each check sent to a provider.
The PRA is a member-by-member accounting of the amount billed, the amount disallowed (if any), any copayments, coinsurance or deductible amounts and reserves as well as the amount reimbursed.
Reason codes which explain why a claim is processed in a particular fashion, are explained at the end of each PRA.
Members are listed alphabetically by last name, and identified by the provider’s own in-house patient account number if this information was included on the original claim at submission.
View sample Provider Remittance Advice with field explanations.
Read more about Electronic Provider Remittance Advice (EPRA).
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