EDI 820 Premium Payment File: Format, Key Segments, and 834 Reconciliation
Imagine receiving a carrier suspense file showing 200 premium payment records that couldn't be matched to members in the enrollment system. Your AR team is now manually cross-referencing spreadsheets to figure out which enrollments the carrier missed, which terminations payroll didn't catch, and which IDs don't match. This scenario plays out monthly at organizations where payment/enrollment mismatches create expensive manual rework.