CNC Remittance

For all contracts, payment (remittance) is sent from the payor to CNC. CNC disperses the appropriate payment to your office. Your remittance check will be accompanied by the CNC Remittance Summary form(s) and copies of the EOB received from the claims payor.

CNC issues bulk provider payments on the 10th, 20th and 30th of each month, or the next business day. All monies received by CNC during the check cut periods are sent to you in the next CNC provider check packet.

In order to assure that your patient's accounts are current and that your accounts receivable figures are accurate, it is important that you post these payments as quickly as possible after receiving the remittance.

When posting CNC payments, please remember that you do not post the CNC admin fee to your patient's accounts. (Please see Posting Instructions below.) Also, please remember that CNC does not adjudicate claims. We do not make any determination regarding the payments or denials of your services. All such decisions are made by the payor, not CNC. The "remark code" shown on the EOB for each service rendered represents the payor's explanation for the action taken on the particular CPT code.

If you receive an EOB showing an incorrectly processed CPT code or any other processing error, PLEASE contact your CNC Provider Rep for assistance. Please CLICK HERE for additional information on denials/problem claims.

PLEASE REMEMBER, YOU ARE REQUIRED TO KEEP ALL EOB’S RECEIVED WITH YOUR CNC REMITTANCE FOR 7 YEARS.

Your CNC check packet will include the following

1. CNC Remittance check (if applicable)

2. Provider Statement - this is a confirmation page of the total amount of the check you received from CNC.

3. Remittance Summaries with EOB's attached - Your Remittance Summary is a summary of the total amounts included on each EOB, the CNC admin fee and the actual dollar amount paid to you in your CNC check.

4. Often CNC includes important notices for you and your billing staff regarding CNC contracts and other important information from the payors, such as a request for additional information regarding a specific claim. Please be sure to pay close attention to any CNC notices included in your check cut packet and make sure it is distributed to all appropriate staff members.

POSTING INSTRUCTIONS FOR YOUR

CNC REMITTANCE

If you are a NEW CNC provider, please call us when you receive your first CNC remittance and we will assist you with any questions you may have about properly posting your CNC remittance.

Post to your patient's accounts using ONLY the EOB/NOP. (Please note, the CNC admin fee should never be posted to your patient account. See the policy on Balance Billing).

Make certain the amount you post to each patient's account is exactly the amount shown as "amount paid" on the EOB for the patient.

The difference between the "billed charges" and the "contracted charges" on the EOB should be adjusted from each patient's account as a contractual adjustment/write-off. You cannot "balance bill" the patient for this amount. The correct amount to write off as your contractual adjustment can normally be found in the "disallowed amount" column on the EOB.

Don't forget to post ZERO dollar payments ($0.00 dollar amounts paid) when no payment was made by the insurance company and transfer this amount to "patient responsibility" when appropriate.

Once you have finished posting each EOB, check to make sure the total amount you have just posted to each of your patient's accounts in your practice management software system is EQUAL to the total amount of the EOB.

Next, compare the amount you posted to your patients' accounts in your practice management software to the TOTAL column of the "Paid by Ins Co" section on the Remittance Summary that accompanies each EOB. If you correctly posted to your patients' accounts, these two numbers will be the same.

Always post ALL of your CNC checks to your patients' accounts BEFORE SUBMITTING REQUESTS FOR CLAIMS TRACING!

The CNC administrative fee should never be posted to the patient’s account. Always post the “paid” amount shown on your EOB when posting to each patient’s account.

Should you receive a payment for a member that is not your patient, use your CNC Fax Inquiry Form and fax a copy of the Remit Summary, a copy of the EOB (circle the patient’s name) and CNC will adjust on your next CNC check.