ARPB_TX_RETRO_HX

Description: |
Lists the retroadjudication review history.

Primary Key

Column Name | Ordinal Position |
--- | --- | ---
TX_ID | 1 |
LINE | 2 |

Column Information

| Name | Type | Discontinued? |
--- | --- | --- | --- | ---
1 | TX_ID | NUMERIC | No |
The unique identifier for the transaction record.
2 | LINE | INTEGER | No |
The line number for the information associated with this record. Multiple pieces of information can be associated with this record.
3 | ACTION_C_NAME | VARCHAR | No |
Stores whether retroadjudication was accepted or rejected for the transaction.
May contain organization-specific values: No
Category Entries:
Accepted
Rejected
Automatically Accepted
Automatically Rejected
Instant Retro
4 | ACTION_DATE | DATETIME | No |
Date the charge was accepted or rejected for retroadjudication
5 | REJECT_REASON_C_NAME | VARCHAR | No |
The reason retroadjudication was rejected for the transaction.
May contain organization-specific values: Yes
Category Entries:
Not a Charge Transaction
Voided Transaction
Out Of Max Days Range
Already Retroadjudicated
Retroadjudication Not Needed
No Open System Batch
In Accepted Queue
In Rejected Queue
Orig Cvg Eff On Svc Dt
Same Cvg, Same Pln/Pln Grp
Same Payer
Supplemental Charge
CRNA Charge
Attached Insurance Payment/Adjustment
Patient Due and Paid Off
Same Payer, Same Plan
Retro Extension Error
Charge Bundled
Small Balance Due
Service Date Too Old
Small Insurance Due
Insufficient Security for Retro
Zero Charge
Matched Credit > 0
Invalid Acct Type
Reject All Chg Extension
Claim Submitted For Orig Payer
Do Not Bill Insurance Charge
Same Payer, Subscriber ID
Invalid Account Status
Dental Payment Plan Charge
Ambulatory Pharmacy Charge
Dental Predetermination Charge
No Effective Date
Bad Debt Transaction
Already Self-Pay
Charge Paid Off
Auto Profile Reject
Tax Charge
Auto Reject due to VFO Conversion
Home Infusion Adjudicated Charge
Plan Swap
6 | ACCEPT_REASON_C_NAME | VARCHAR | No |
The reason retroadjudication was automatically accepted for the transaction.
May contain organization-specific values: Yes
Category Entries:
Other
Charges Not Triggered
Primary Coverage Unchanged
Self-Pay to Coverage
No Claims Sent to Original Payer
7 | RETRO_COMMENT | VARCHAR | No |
Free text comment to further describe the retroadjudication event.
8 | USER_ID | VARCHAR | No |
User responsible for accepting or rejecting retroadjudication
9 | USER_ID_NAME | VARCHAR | No |
The name of the user record. This name may be hidden.
10 | TRIGGER_DATE | DATETIME | No |
The date when the charge was identified as candidate for retroadjudication.
11 | TRIGGER_USER_ID | VARCHAR | No |
Stores a reference to the last user to make changes that caused the charge to be a candidate for retroadjudication.
12 | TRIGGER_USER_ID_NAME | VARCHAR | No |
The name of the user record. This name may be hidden.
13 | ACTION_TIME | DATETIME (Local) | No |
Time the charge was accepted or rejected for retroadjudication.
14 | MANUAL_REASON_C_NAME | VARCHAR | No |
The retroadjudication reason category ID selected in account maintenance for the transactions.
May contain organization-specific values: Yes
Category Entries:
Other
Addition/Deletion/Change in Patients
Change Patient Covered Flag
Change Patient Effective Date
Change Coverage Effective Date
New Coverages
Add Member
Change Member Effective Date
Remove Member
Add Account
Change Benefit Plan on Employer Group
Change Coverage Term Date
Change Member Term Date
Change Covered Status
Change Riders on Employer Group
Remove Benefit Plan from Employer Group
Change Activation Date on Employer Group
Change Termination Date on Employer Group
Change Effective Date due to Group Term Date
Change Term Date due to Group Effective Date
Change Coverages
Change Visit Coverage