Payment
The final step in the processing capabilities of the SCE includes the final payment calculations. This includes the addition of any late payment interest (LPI) as well as setting the final payment amount and member liabilities to apply to the EOBs and provider check run.
The SCE also supports the creation of the appropriate X12 transactions to report claims status and remittance.
Capability | Description |
Payment calculation | The final payment and liabilities are calculated for the provider payment check run.
|
LPI / prompt pay | Any claims that are subject to late payment interest are identified and the appropriate interest calculations made and applied to the claim.
|
Payment info | Check or EFT information is applied to the claim based on the outcome of the check run process
|
Claim/payment response | The SCE can create X12 remittance and claims status information, as well as support claim status inquiries.
|
Previous topic Finalization Next topic Accumulator management