The full definition
ASC X12 835 is the electronic remittance advice format payers use to tell providers how a submitted claim was adjudicated. The 835 contains the paid amount, any adjustments (contractual write-offs, denials, partial payments), patient responsibility (copay, deductible, coinsurance), and reason codes for any denial. Modern billing platforms ingest 835s automatically and post payments + adjustments to the patient ledger without manual data entry.
Why it matters in practice
ERA auto-reconciliation is one of the biggest time-savers in healthcare billing — without it, billers spend hours per week manually keying in payments from paper EOBs. With auto-reconciliation, the payment posts itself and the biller only handles exceptions (denials, partial payments needing review).
Real-world examples
- Receiving an 835 from Aetna confirming $285 was paid on a $300 billed claim with $15 adjustment
- Receiving an 835 with a denial reason code requiring claim resubmission with corrected information
- Receiving a Medicare 835 with patient deductible status updates
Inside Velant
Velant retrieves and auto-reconciles 835 ERAs at $0.14 per ERA with automatic payment posting and denial routing into the appeals workflow.
Related terms
- 837P Electronic Claim SubmissionThe HIPAA-standard electronic claim format for professional services (physician, behavioral health, outpatient) — the most common claim type for non-hospital providers.
- 270/271 Real-Time Eligibility VerificationThe HIPAA standard transaction pair used to verify a patient's insurance coverage in real time. 270 is the request to the payer; 271 is the response.
- HIPAA-Compliant CRMA customer relationship management system designed to handle Protected Health Information (PHI) in accordance with the Health Insurance Portability and Accountability Act of 1996.