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Disbursement Hub

  • Explanation of Benefits
  • Explanation of Payment
  • Payment File
  • Response File
    • Member Payment Level File
    • Member Claim Level File
    • Provider Payment Level File
    • Provider Claim Level File
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InstaMed Developer Portal
  • General Integration
  • Consumer Payments
  • Consumer Billing
  • Healthcare
  • Disbursement Hub
  • Explanation of Benefits
  • Explanation of Payment
  • Payment File
  • Response File
    • Member Payment Level File
    • Member Claim Level File
    • Provider Payment Level File
    • Provider Claim Level File
  • Request Sandbox API Key
  • Contact
  • Terms of Service

Provider Payment Level File

InstaMed supports the ability to send payments (and denials) to providers (Explanation of Payment or EOP). These outbound payments consist of claims adjudicated by a health plan and owed to a provider.

In order to properly reflect the disposition of an adjudicated claim, issued via the InstaMed Disbursement Hub solution, InstaMed supports the generation of payment-level batch files.

For example, if a check payment is issued for $1,000, a single record would be reported in the batch file with a ‘Paid’ status regardless of how many claims are applicable to the check payment. InstaMed will output another batch file in the future when the check is deposited to change the status of the payment from ‘Paid’ to ‘Settled’.

The specification below is used to report on the status of specific payments issued by InstaMed as part of a payment/835 transaction.

Files are output in a pipe delimited format and uploaded to client-specific SFTP directories.

Field #Field NameFormatMinMaxRequiredComment
1Record ID"IMRPA10"77Y
2DisbursementTraceNumberAN130STRN02 Disbursed check/trace number to provider; Available when transaction status is paid
3DisbursementEntityAN1042STRN03:TRN04 Available when transaction status is Paid
4OriginalTraceNumberAN130SFrom original file TRN02
5OriginalDisbursedPaymentTraceNumberAN130SCPC Re-Issues
6ReissuedPaymentTraceNumberAN130SCPC Re-Issues
7Funding Entity IDAN1042SFrom original file TRN03:TRN04
8PaymentDateAN88SYYYYMMDD, Available when transaction status is Paid
9PaymentMethodAN130SACH, CHK, NON, Virtual Card
10PaymentAmountDECY
11SettlementAmountDECS
12Payer NameAN135YN102 when N101 = PR
13Payee LastAN135YN102 when N101 = PE
14Payee FirstAN135S
15Payee Primary ID QualifierAN22YN103 when N101 = PE
16Payee Primary IDAN180YN104 when N101 = PE
17Tax IDAN180SREF*TJ segment
18StatusAN120YPAID: Payment was disbursed to provider
RETURNED: Returned payment
SETTLED: Settled payments
CANCELLED: Cancelled, Reissued, or Expired virtual card payments
PENDING FUNDING: Payments that are available for approval in InstaMed Online
SUSPENDED: Suspended payments
PARTIALLY SETTLED: Partially settled payments
VOIDED: Voided payments
EXPIRED: Expired claim payment card payments
STOPPED: A check has been voided or stopped by the bank
19Return CodeAN33SPopulated when Message Status = Returned
20Return ReasonAN1100SPopulated when Message Status = Returned
21Provider AdjustmentsDECS
22Claim CountNUMY
23Funding DateAN88S
24FundingTraceNumberAN130S
25Funding StatusAN130SPending Funding
Pending Replenishment
Replenished
Funded
26Placeholder Field 6ANReserved for future use
27Placeholder Field 7ANReserved for future use
28Placeholder Field 8ANReserved for future use
29Placeholder Field 9ANReserved for future use
30Placeholder Field 10ANReserved for future use
31Placeholder Field 11ANReserved for future use
32Placeholder Field 12DECReserved for future use
33Placeholder Field 13DECReserved for future use
34Placeholder Field 14DECReserved for future use
35Placeholder Field 15DECReserved for future use
36Mail DateAN88OYYYYMMDD
Date that print vendor placed item into mailstream; Always populated for CHK and Virtual Card

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InstaMed is a wholly owned subsidiary and is a registered MSP/ISO of JPMorgan Chase Bank, N.A. Additionally, InstaMed is a registered ISO of Wells Fargo Bank, N.A., Concord, CA; a registered ISO of U.S. Bank, N.A.; and a registered MSP/ISO of Elavon, Inc. Georgia.

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