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 system comprising one or more processors and at least one memory storing processor executable instructions that, when executed by the one or more processors, cause the one or more processors to perform operations comprising:
receiving, over a computer network, a data file comprising (1) instructions to pay one or more adjudicated claims in an authorized amount to a healthcare provider having a unique identifier, and (2) a remittance advice file originating in response to one or more claims previously submitted by the healthcare provider;
electronically requesting, from a payment issuing authority, electronic payment data for the authorized amount corresponding to the one or more adjudicated claims;
generating an authorization code for an electronic payment authorization request associated with the data file;
setting the authorization code to a claim identifier value provided in the one or more claims previously submitted by the healthcare provider, wherein an authorization response associated with the electronic payment authorization request includes the claim identifier value as the authorization code;
generating a modified remittance advice file by inserting the authorization code into the remittance advice file; and
electronically sending, to the healthcare provider, the modified remittance advice file and the electronic payment data, wherein the authorization code links funds received through an electronic payment transaction to the modified remittance advice file such that the healthcare provider can automatically reconcile a payment received through the electronic payment transaction with the modified remittance advice file.
2 . The system of claim 1 , wherein the electronic payment data comprises a virtual payment card.
3 . The system of claim 1 , wherein the remittance advice file and the modified remittance advice file are in a first format and the one or more claims previously submitted by the healthcare provider are in a second format.
4 . The system of claim 1 , wherein the electronic payment data is configured to be charged an amount equal to the authorized amount for payment of the one or more adjudicated claims.
5 . The system of claim 1 , wherein the unique identifier comprises a tax identification number.
6 . A computer-implemented method, comprising:
receiving, by one or more processors and over a computer network, a data file comprising (1) instructions to pay one or more adjudicated claims in an authorized amount to a healthcare provider having a unique identifier, and (2) a remittance advice file originating in response to one or more claims previously submitted by the healthcare provider;
electronically requesting, by the one or more processors and from a payment issuing authority, electronic payment data for the authorized amount corresponding to the one or more adjudicated claims;
generating, by the one or more processors, an authorization code for an electronic payment authorization request associated with the data file;
setting, by the one or more processors, the authorization code to a claim identifier value provided in the one or more claims previously submitted by the healthcare provider, wherein an authorization response associated with the electronic payment authorization request includes the claim identifier value as the authorization code;
generating, by the one or more processors, a modified remittance advice file by inserting the authorization code into the remittance advice file; and
electronically sending, by the one or more processors and to the healthcare provider, the modified remittance advice file and the electronic payment data, wherein the authorization code links funds received through an electronic payment transaction to the modified remittance advice file such that the healthcare provider can automatically reconcile a payment received through the electronic payment transaction with the modified remittance advice file.
7 . The computer-implemented method of claim 6 , wherein the electronic payment data comprises a virtual payment card.
8 . The computer-implemented method of claim 6 , wherein the remittance advice file and the modified remittance advice file are in a first format and the one or more claims previously submitted by the healthcare provider are in a second format.
9 . The computer-implemented method of claim 6 , wherein the electronic payment data is configured to be charged an amount equal to the authorized amount for payment of the one or more adjudicated claims.
10 . The computer-implemented method of claim 6 , wherein the unique identifier comprises a tax identification number.
11 . One or more non-transitory computer-readable storage media storing instructions that, when executed by one or more processors, cause the one or more processors to perform operations comprising:
receiving, over a computer network, a data file comprising (1) instructions to pay one or more adjudicated claims in an authorized amount to a healthcare provider having a unique identifier, and (2) a remittance advice file originating in response to one or more claims previously submitted by the healthcare provider;
electronically requesting, from a payment issuing authority, electronic payment data for the authorized amount corresponding to the one or more adjudicated claims;
generating an authorization code for an electronic payment authorization request associated with the data file;
setting the authorization code to a claim identifier value provided in the one or more claims previously submitted by the healthcare provider, wherein an authorization response associated with the electronic payment authorization request includes the claim identifier value as the authorization code;
generating a modified remittance advice file by inserting the authorization code into the remittance advice file; and
electronically sending, to the healthcare provider, the modified remittance advice file and the electronic payment data, wherein the authorization code links funds received through an electronic payment transaction to the modified remittance advice file such that the healthcare provider can automatically reconcile a payment received through the electronic payment transaction with the modified remittance advice file.
12 . The one or more non-transitory computer-readable storage media of claim 11 , wherein the electronic payment data comprises a virtual payment card.
13 . The one or more non-transitory computer-readable storage media of claim 11 , wherein the remittance advice file and the modified remittance advice file are in a first format and the one or more claims previously submitted by the healthcare provider are in a second format.
14 . The one or more non-transitory computer-readable storage media of claim 11 , wherein the electronic payment data is configured to be charged an amount equal to the authorized amount for payment of the one or more adjudicated claims.
15 . The one or more non-transitory computer-readable storage media of claim 11 , wherein the unique identifier comprises a tax identification number.