Which level is NOT a remittance code mapping level?

Which level is NOT a remittance code mapping level?

• A. Plan
• B. Payer
• C. Service Area
• D. Billing Group

Answer: (D)

Remittance code mappings are defined to apply at specific scopes that determine how a payer’s remittance advice is translated into internal codes. The levels commonly used are plan, payer, and service area because remittance differences can depend on the particular plan terms, the payer's overall policies, or the service location. Billing group is simply a way to organize and batch claims for billing processes within an organization; it does not establish a remittance mapping scope. Therefore, it is not a remittance code mapping level.

Remittance code mappings are defined to apply at specific scopes that determine how a payer’s remittance advice is translated into internal codes. The levels commonly used are plan, payer, and service area because remittance differences can depend on the particular plan terms, the payer's overall policies, or the service location.

Billing group is simply a way to organize and batch claims for billing processes within an organization; it does not establish a remittance mapping scope. Therefore, it is not a remittance code mapping level.