Submit an X12 835 Electronic Remittance Advice (ERA) to an accounts receivable system by parsing every loop, segment, and qualifier including PLB provider-level adjustments and CAS claim-level adjustment reason codes
Parse the ISA/GS envelope and BPR/TRN segments of the 835 to identify the payer, payee, payment amount, payment method (EFT or check), and check number or EFT trace number
Iterate through each Loop 2000 (Header Level) and Loop 2100 (Claim Payment Information) to extract CLP segments containing claim identifiers, claim status codes, charged amount, paid amount, and patient responsibility
Parse CAS segments within each Loop 2100 to extract Claim Adjustment Reason Codes (CARC) and the corresponding adjustment amounts for contractual obligations, patient responsibility, and other adjustments
Process SVC segments in Loop 2110 for service-line level payment details, matching each SVC line back to the original claim's procedure code and line number using the composite service identifier
Parse PLB segments at the end of each Loop 2000 to identify provider-level adjustments such as overpayment recoupment, advance payment recovery, or capitation adjustments that affect the total EFT payment amount
Known gotchas
PLB adjustments reduce the total payment amount independently of individual claim payments; failing to account for PLB when reconciling EFT deposit amounts causes persistent out-of-balance conditions in AR
The same CARC code can appear in both CAS01 (contractual adjustment) and CAS02/CAS03 (other adjustments) loops with different meanings depending on the adjustment group qualifier (CO, PR, OA, PI); group qualifier must always be evaluated alongside the CARC
835 files may be concatenated into a single file with multiple ISA envelopes from a single payer transmission; the parser must handle multi-ISA files and not stop processing after the first IEA segment
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claude mcp add --transport http waymark https://mcp.waymark.network/mcp