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It’s
Over the weekend, Friday’s 835 remittance files landed perfectly in your data lake. Every Claim Adjustment Reason Code (CARC) and Provider Level Adjustment (PLB) code was parsed, decoded, and normalized. Out of the 412 claims in the file, 38 are short-paid. The timely-filing window on the oldest denial is 27 days out.
Instead, she spends her morning manually walking the 2100 and 2110 loops, the nested claim and service-line details buried inside every EDI file, in a SQL query, pasting short pays into a spreadsheet, and reconciling them against a payment register. By the time she actually picks up the phone to fight a denial, half her day is gone.
