Remittance processing can be a little complicated due to the MOHLTC's addition of adjustments or if you are billing with multiple systems including CabMD. Here's a simple breakdown of how you can look into payment of your claims monthly.
The first week of every month, CabMD should recieve the remittance file for your claims if you have submitted any claims before the cut off date in the previous month. You can see if we've downloaded the file and it's status by:
- Logging in to your CabMD account
- Browsing to File Centre > EDT Files
- Filtering by file type
If it's after the 1st of the month and you don't see a remittance file for this month, then we haven't retrieved it from your account yet*. Just wait and double check that your EDT account information is correct and working.
If we have been able to download the file but the status is not
Processed then just wait - we process files periodically.
Processing of the file is what moves your claims from Submitted to Paid statuses in your account. You can't run any paid claims report until we've processed the remittance file, as the report relies on that data. Also of note is that the paid claims report is based on the date the remittance file is processed and not based on the claim service dates or the date you entered the claims - this is a common misconception.
When the remittance file is processed, then it's report time!
Generally, every month you will want to run two reports:
- Paid Claims Detailed/Summary Report
This can be found under Reports > Reports. This is a report of CabMD claims only and details what you've submitted vs what was paid and any explanation details for any modified payments.
- Remittance Report
This can be found under File Centre > EDT Files, on each remittance file you'll see the remittance report icon. This is a report that details all non-claim information from your remittance file including Payable Amount, adjustments and any MOHLTC notes that pertain to your remittance.
If you notice that your paid claims report doesn't match the payable amount, that can be for a number of reasons:
- You have non-CabMD claims in your remittance file.
We assume that you are using other software to submit the non-CabMD claims and as such you should be running the remittance data through those systems as well. We're 100% confident that we match only CabMD claims based on all the claim data including our unique accounting numbers.
- You have adjustments in your Remittance Report which aren't included in the Paid Claims Report.
To account for these, open your remittance report and account for the total sum of adjustments. The sum of paid claims and adjustments should equal your payable amount in most circumstances (unless you have non-CabMD claims).