Claims are processed on our Regence MedAdvantage claims system. These vouchers will look different than other Regence vouchers. An explanation of the key information provided on the voucher is listed below. Download a sample payment voucher (PDF).

Item A

• Physician, other health care professional or facility name
• Regence provider identification number
• National Provider Identifier (NPI) number
• Regence MedAdvantage product name
• Voucher page number
• Date of the check that accompanies the voucher

Item B

• Patient name
• Member identification number
• Patient account number (if one was submitted on the claim)
• Member's Regence MedAdvantage group number
• Claim number

Item C

• CPT, CDT, or HCPCS codes billed
• Written description of the service
• First and last dates of service
• Total charge for the service
• Fee adjustment or the amount not covered by the member's plan. The member may not be held responsible for this amount
• Amount paid by another carrier
• Amount of patient responsibility. This amount includes copayment, coinsurance, deductible or any non-covered services
• The reason code explaining how this particular claim was processed. Refer to the last page of the voucher for descriptions
• Amount paid by Regence MedAdvantage

Item D

• Claim voucher totals

Item E

• Description of the reason code entered in the column in Section C

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