New: Drop-in replacement for Change Healthcare APIs

EDI 820 Payment Order/Remittance Advice

Functional Group RA

X12F Finance Subcommittee

Heading

1. 02 · ST · Transaction Set Header · Max 1 · Mandatory

   To indicate the start of a transaction set and to assign a control number

2. 03 · BPS · Beginning Segment (Payment Order/Remittance Advice) · Max 1 · Mandatory

   To (1.) indicate the beginning of a payment order/remittance advice transaction set and total payment amount and (2.) to enable related transfer of funds and/or information from payor to payee to occur while utilizing an automated clearing house (ACH) or other banking network.

3. 04 · NTE · Note/Special Instruction F · Max 100

   To transmit information in a free-form format, if necessary, for comment or special instruction

4. 05 · CUR · Currency · Max 1 · Optional

   To specify the currency (dollars, pounds, francs, etc.) used in a transaction

5. 06 · REF · Reference Numbers · Max 5 · Mandatory

   To transmit identifying numbers associated with the named party

6. 07 · DTM · Date/Time Reference · Max 10 · Mandatory

   To specify pertinent dates and times

7. N1 Loop Optional Repeat 200

   1. 08 · N1 · Name · Max 1 · Mandatory

      To identify a party by type of organization, name and code

   2. 09 · N2 · Additional Name Information · Max 2 · Optional

      To specify additional names or those longer than 35 characters in length

   3. 10 · N3 · Address Information · Max 2 · Optional

      To specify the location of the named party

   4. 11 · N4 · Geographic Location · Max 1 · Optional

      To specify the geographic place of the named party

   5. 12 · REF · Reference Numbers · Max 12 · Optional

      To transmit identifying numbers associated with the named party

   6. 13 · PER · Administrative Communications Contact · Max 3 · Optional

      To identify a person or office to whom administrative communications should be directed

Detail

1. 15 · LS · Loop Header · Max 1 · Mandatory

   To indicate that the next segment begins a loop

2. N1 Loop Mandatory Repeat 10000

   1. 16 · N1 · Name · Max 1 · Mandatory

      To identify a party by type of organization, name and code

   2. RMT Loop Mandatory Repeat 10000

      1. 17 · RMT · Remittance Advice · Max 1 · Mandatory

         To indicate the detail on items being paid.

      2. 18 · CUR · Currency · Max 1 · Optional

         To specify the currency (dollars, pounds, francs, etc.) used in a transaction

      3. 19 · REF · Reference Numbers · Max 5 · Optional

         To transmit identifying numbers associated with the named party

      4. 20 · DTM · Date/Time Reference · Max 10 · Optional

         To specify pertinent dates and times

3. 21 · LE · Loop Trailer · Max 1 · Mandatory

   To indicate that the loop immediately preceding this segment is complete

Summary

1. 23 · SE · Transaction Set Trailer · Max 1 · Mandatory

   To indicate the end of the transaction set and provide the count of the transmitted segments (including the beginning and ending (SE) segment)