RMR

Organization Summary Remittance Detail

Pos: 150	Max: 1
Detail - Optional
Loop: 2300A	Elements: 5

Ref

Id

Element Name

Req

Type

Min/Max

Usage

RMR01

128

Reference Identification Qualifier
Description: Code qualifying the Reference Identification

C

ID

2/3

Required

Code

Name

11

Account Number

1L

Group or Policy Number

In addition to private sector health care contract numbers, Group or Policy Number can be used to identify the Federal Employees Health Benefits Program (FEHB) “Enrollment Code” being paid. The FEHB Enrollment Code identifies an insurer’s specific health benefits plan. For HIPAA Health Premium Payments this code is REQUIRED when an invoice has not been received from the Health Plan.

CT

Contract Number

IK

Invoice Number

RMR02

127

Reference Identification
Description: Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
Health Care Industry: Contract, Invoice, Account, Group, or Policy Number

C

AN

1/30

Required

RMR03

482

Payment Action Code
Description: Code specifying the accounts receivable open item(s), if any, to be included in the cash application.
This is required when the sender needs to indicate to the receiver how to apply payment.
For HIPAA Health Premium Payments this element is NOT USED.

O

ID

2/2

Situational

Code

Name

PA

Payment in Advance

PI

Pay Item

PO

Payment on Account

PP

Partial Payment

RMR04

782

Monetary Amount
Description: Monetary amount
Health Care Industry: Detail Premium Payment Amount
The amount being paid on this remittance item.

O

R

1/18

Required

RMR05

782

Monetary Amount
Description: Monetary amount
Health Care Industry: Billed Premium Amount
This is required when the Insurer sent an Invoice and the paid amount is different than the amount invoiced.

O

R

1/18

Situational

1.

P0102 - If either RMR01,RMR02 is present, then all are required

2.

P0708 - If either RMR07,RMR08 is present, then all are required

1.

If RMR03 is present, it specifies how the cash is to be applied.

2.

RMR04 is the amount paid.

3.

RMR05 is the amount of invoice (including charges, less allowance) before terms discount (if discount is applicable) or debit amount or credit amount of referenced items.

4.

RMR06 is the amount of discount taken.

5.

RMR08, if present, represents an interest penalty payment, amount late interest paid, or amount anticipation.

1.

Parties using this segment should agree on the content of RMR01 and RMR02 prior to initiating communication.

2.

If RMR03 is not present, this is a payment for an open item. If paying an open item, RMR02 must be present. If not paying a specific open item, RMR04 must be present.

3.

RMR05 may be needed by some payees to distinguish between duplicate reference numbers.

Notes:

1. Used to provide detailed remittance information related to summary bill payment.

Example:

RMR*IK*123456789*PI*250.00~