If an electronic remittance advice (ERA) can have a different NPI than submitted on the claim, how can I tell which claim the ERA is responding to?
The submitter’s claim number (from CLM01 in an 837 EDI claim) is returned in the CLP01 element in the 835 ERA, and this is not affected by the NPI regulations or related changes. The 835 ERA implementation guide states the following about the CLP01: “This data element is the primary key for posting the remittance information into the provider’s database. We also recommend that it be used for that purpose rather than matching by provider IDs.” Matching remittances to claims using the provider ID is normally not necessary.
