835 — Remittance Advice (ERA)

The 835 transaction carries Electronic Remittance Advice — payment and adjustment details from a payer in response to submitted claims. RCMbox provides a built-in mapping activity (map-835-to-claim-responses) that converts parsed 835 data into FHIR ClaimResponse resources.

What the built-in mapping extracts

• CLP loop — each claim-level payment becomes a draft ClaimResponse
• CAS segments — Claim Adjustment Reason Codes (CARC) mapped to adjudication entries
• LQ segments — Remittance Advice Remark Codes (RARC) for additional context
• SVC segments — service line detail with charged, paid, and allowed amounts
• Contained resources — Patient (from QC NM1), Payer (from 1000A), Payee (from 1000B)
• Identifiers — Patient Control Number (PCN), payer claim control number

Used in

• Upload ERA workflow
• Link ClaimResponse workflow (downstream)