Payment card reconciliation by authorization code
A payment processor acting on behalf of a third party administrator to make payment on an adjudicated claim makes a straight through payment to an acquirer for a health care provider's merchant account. Via the authorization process, the payment processor generates an authorization code which is returned to the health care provider on its merchant statement for the payment. Concurrently, the remittance advice from the third party administrator is linked to the same authorization code as the payment by the payment processor which sends the advice in an 835-formatted transmission to the health care provider. Thus, the remittance advice may be linked (reconciled) with the payment on the merchant statement by the common authorization code.
1. A computer-implemented method of minimizing transmissions of sensitive payment data and automatically reconciling claims with electronic payment transactions for a healthcare provider, the method comprising the steps of:
receiving, over a computer network, a data file by a payment processor computing system, wherein the data file is sent from a remote administrator computer, the data file further including:
instructions to pay one or more adjudicated claims in an authorized amount to a healthcare provider having a tax identification number;
a remittance advice file originating in response to one or more claims previously submitted by the healthcare provider;
electronically requesting, by the payment processor computing system, electronic payment, wherein the electronic payment is configured to be charged an amount equal to the authorized amount for payment of the one or more adjudicated claims;
electronically sending, by the payment processor computing system, the healthcare provider's tax identification number and the electronic payment data to a merchant acquirer for the healthcare provider, wherein the merchant acquirer electronically requests authorization for the electronic payment data in an amount equal to the authorized amount to be paid to the healthcare provider for the one or more adjudicated claims;
generating an authorization code for the electronic payment authorization request, by the payment processor computing system;
setting, by the payment processor computing system, the authorization code to a claim identifier value provided in the one or more claims previously submitted by the healthcare provider, whereby the authorization response includes the claim identifier value as the authorization code;
inserting the authorization code into the remittance advice file to digitally create a modified remittance advice file; and
electronically sending the modified remittance advice file from the payment processor computing system to the healthcare provider, whereby the authorization code links funds received through an electronic payment transaction to the modified remittance advice file such that the healthcare provider's practice management software can automatically reconcile the payment received through the electronic payment transaction with the modified remittance advice file.
2. The method of claim 1 , wherein the modified remittance advice file is computer readable and electronically sent to the healthcare provider from the payment processor computing system.
3. A computer-implemented method of minimizing transmissions of sensitive payment data and automatically reconciling claims with electronic payment transactions for a healthcare provider, the method comprising the steps of:
Receiving, over a computer network, a data file by a payment processor computing system, wherein the data file is sent from a remote administrator computer, the data file further including:
instructions to pay one or more adjudicated claims in an authorized amount to a healthcare provider having a tax identification number;
a remittance advice file originating in response to one or more claims previously submitted by the healthcare provider;
electronically requesting, by the payment processor computing system, electronic payment from a payment issuing authority, wherein the electronic payment is configured to be charged an amount equal to the authorized amount for payment of the one or more adjudicated claims;
electronically sending, by the payment processor computing system, the healthcare provider's tax identification number and the electronic payment data to a merchant acquirer for the healthcare provider, wherein the merchant acquirer electronically requests authorization for the electronic payment data in an amount equal to the authorized amount to be paid to the healthcare provider for the one or more adjudicated claims;
generating an authorization code for the electronic payment authorization request, by the payment processor computing system;
setting, by the payment processor computing system, the authorization code to a claim identifier value provided in the one or more claims previously submitted by the healthcare provider, whereby the authorization response sent by the payment issuing authority includes the claim identifier value as the authorization code; and
inserting the authorization code into the remittance advice file to digitally create a modified remittance advice file; and
electronically sending the modified remittance advice file from the payment processor computing system to the healthcare provider, whereby the authorization code links funds received through an electronic payment transaction to the modified remittance advice file such that the healthcare provider's practice management software can automatically reconcile the payment received through the electronic payment transaction with the modified remittance advice file.
4. The method of claim 3 , wherein the modified remittance advice file is computer readable and electronically sent to the healthcare provider from the payment processor computing system.
5. A computer-implemented method of minimizing transmissions of sensitive payment data and automatically reconciling claims with electronic payment transactions for a healthcare provider, the method comprising the steps of:
receiving, over a computer network, a data file by a payment processor computing system, wherein the data file is sent from a remote administrator computer, the data file further including:
instructions to pay one or more adjudicated claims in an authorized amount to a healthcare provider having a tax identification number;
a remittance advice file originating in response to one or more claims previously submitted by the healthcare provider;
electronically requesting, by the payment processor computing system, electronic payment, wherein the electronic payment is configured to be charged an amount equal to the authorized amount for payment of the one or more adjudicated claims;
electronically sending, by the payment processor computing system, the electronic payment data to the healthcare provider, whereby the healthcare provider can electronically request authorization for the electronic payment data in an amount equal to the authorized amount to be paid to the healthcare provider for the one or more adjudicated claims;
generating an authorization code for the electronic payment authorization request, by the payment processor computing system;
setting, by the payment processor computing system, the authorization code to a claim identifier value provided in the one or more claims previously submitted by the healthcare provider, whereby the authorization response includes the claim identifier value as the authorization code;
inserting the authorization code into the remittance advice file to digitally create a modified remittance advice file; and
electronically sending the modified remittance advice file from the payment processor computing system to the healthcare provider, whereby the authorization code links funds received through an electronic payment transaction to the modified remittance advice file such that the healthcare provider's practice management software can automatically reconcile the payment received through the electronic payment transaction with the modified remittance advice file.
6. The method of claim 5 , wherein the modified remittance advice file is computer readable and electronically sent to the healthcare provider from the payment processor computing system.