HSP_BDC_DENIAL_DATA

Description: |
This table contains denial information stored in the Denial/Remark/Correspondence records in the Denial/Correspondence (BDC) master file. There can be multiple lines of data for each record. Each line represents one claim/explanations of benefits (EOB) line that was denied.

Primary Key

Column Name | Ordinal Position |
--- | --- | ---
BDC_ID | 1 |
LINE_COUNT | 2 |

Column Information

| Name | Type | Discontinued? |
--- | --- | --- | --- | ---
1 | BDC_ID | NUMERIC | No |
This column stores the unique identifier for the denial or correspondence record.
2 | LINE_COUNT | INTEGER | No |
Line number of denial data. There can be multiple lines of denial data and this is the number of the line that enterprise reporting is extracting.
3 | LINE_ON_EOB | INTEGER | No |
This column stores the line on explanation of benefits that was denied. "-1" represents the total denial data that is the sum of the invoice-level and sum of line-level data. "0" represents the invoice-level data.
4 | LINE_BILLED_AMOUNT | NUMERIC | No |
Billed amount on the claim line that was denied. If the denial was at the invoice level - this is the billed amount for the entire claim
5 | LINE_ALLWD_AMT | NUMERIC | No |
The payment allowed amount for claim line that was denied. If the denial was for the entire invoice this is the allowed amount on the entire payment.
6 | LINE_PAID_AMT | NUMERIC | No |
This column stores the amount paid for the line that was denied. $0.00 if fully denied, >0 if partially denied. If the denial was for the entire invoice then this is the amount paid for the entire claim.
7 | LINE_DENIED_AMT | NUMERIC | No |
Denied amount for claim line that was denied. If the denial is for the entire invoice then this is the denied amount for the claim.
8 | LINE_COMMENTS | VARCHAR | No |
This column stores comments on explanation of benefits for denied line.
9 | LINE_REVENUE_CODE_ID | NUMERIC | No |
This column stores the unique identifier for the line-level revenue code for the denial.
10 | LINE_REVENUE_CODE_ID_REVENUE_CODE_NAME | VARCHAR | No |
The name of the revenue code.
11 | LINE_CPT_CODE | VARCHAR | No |
This item stores the line-level CPT(R) code for the denial.
12 | LINE_PRIMARY_CHARGE_TX_ID | NUMERIC | No |
Charge with the greatest amount from the claim line that was denied. If two charges have the same amount the older one will be the primary charge.
13 | LINE_SERVICE_DATE | DATETIME | No |
The line level service date of the denial.
14 | LINE_QUANTITY | NUMERIC | No |
The line level quantity for the denied line.
15 | LINE_ON_CLAIM | INTEGER | No |
This item stores the line-level expected allowed amount for the denied claim line.
16 | LINE_EXPECTED_ALLOWED_AMT | NUMERIC | No |
This item stores the line-level expected allowed amount for the denied claim line.
17 | CLAIM_LN_REV_CODE_ID | NUMERIC | No |
The revenue code ID indicated on the claim for this service line.
18 | CLAIM_LN_REV_CODE_ID_REVENUE_CODE_NAME | VARCHAR | No |
The name of the revenue code.
19 | CLAIM_LN_CPTCODE | VARCHAR | No |
The CPT code indicated on the claim for this service line.
20 | CLAIM_LINE_MODIFIER | VARCHAR | No |
A comma-delimited list of the modifiers indicated on the claim for this service line.
21 | CLAIM_LINE_SVC_DATE | DATETIME | No |
The service date indicated on the claim for this service line.
22 | CLAIM_LINE_QUANTITY | NUMERIC | No |
The quantity indicated on the claim for this service line.
23 | LINE_PMT_SRC_TX_ID | NUMERIC | No |
The contributing payment which is the data source for this line. This item will only be set for HB variance records, which may have more than one contributing payment.