How do I read a Medicaid remittance advice (835)?
A remittance advice is the payer’s report of what happened to each claim: paid, denied, or adjusted, and why. The electronic version is called an 835. Match each line to your claim, read the reason code, then post the payment or start the fix. Do not post money until you match it.
The remittance advice (RA) is your answer sheet. The electronic form is the 835, also called an ERA.
In Georgia, the 835 goes to the payee, or to a trading partner you have named, after claims are accepted and sent to adjudication. Files stay downloadable for six weeks, so pull them on time.
How to read one:
- Find the claim by client ID and date of service.
- Look at the status: paid, denied, or adjusted.
- Compare billed amount to paid amount. A gap is not always a denial. Some lines are paid at the allowed rate.
- Read the reason code on any line that was cut or denied.
- Post the payment against the right claim.
- Make a to-do for every denial, with its deadline.
Georgia also sends an unsolicited claim status report for claims with processing problems or pended status.
Store each RA with its claim. If an auditor asks why you were paid, the RA is part of the answer. If the code is unclear, call the state’s provider help line before you resubmit.
Sources
- Gainwell EDI FAQs (Nov 2022) · Georgia Medicaid (GAMMIS)
- Georgia Medicaid Common Denials webinar (Feb 2021) · Georgia DCH / GAMMIS
Reviewed by Beth Bledsoe, Care Business Advisor®, 28 Oct 2026. Rules change. Confirm with your state Medicaid agency before you act.
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