|
Name |
Type |
Discontinued? |
|
| 1 |
CLAIM_ID |
NUMERIC |
No |
|
|
|
| The unique identifier for the claim record. |
|
|
| 2 |
TOT_ADDL_ADJ |
NUMERIC |
No |
|
|
|
| Stores the total additional adjustments for the claim. |
|
|
| 3 |
AP_CLAIM_IMPORT_SOURCE_C_NAME |
VARCHAR |
No |
|
|
|
| Used to define the type of source a claim is imported from to drive reporting on the different use cases a single workflow type may have. |
| May contain organization-specific values: No |
| Category Entries: |
| Historical System |
| Repricing Source |
| Delegated Payer |
| Clearinghouse |
| Other Internal Source |
| Other External Source |
|
|
| 4 |
SOURCE_GROUP_ID_LOC_NAME |
VARCHAR |
No |
|
|
|
| The name of the revenue location. |
|
|
| 5 |
SERVICE_DATE_FROM_LINE_YN |
VARCHAR |
No |
|
|
|
| Indicates whether the service date was received at the header level, or was determined based on service lines. |
| May contain organization-specific values: No |
| Category Entries: |
| No |
| Yes |
|
|
| 6 |
NCH_CLAIM_TYPE_C_NAME |
VARCHAR |
No |
|
|
|
| The National Claims History (NCH) code indicating the type of claim submitted. |
| May contain organization-specific values: No |
| Category Entries: |
| Home Health Agency (HHA) claim |
| Non swing bed Skilled Nursing Facility (SNF) claim |
| Swing bed Skilled Nursing Facility (SNF) claim |
| Hospital Outpatient claim |
| Hospice claim |
| Inpatient claim |
| Inpatient Full Encounter claim |
| Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim |
| Local carrier durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim |
| Durable medical equipment regional carrier (DMERC); non-DMEPOS claim |
| Durable medical equipment regional carrier (DMERC); DMEPOS claim |
|
|
| 7 |
PAID_CLM_FILE_INTEREST_AMT |
NUMERIC |
No |
|
|
|
| The total interest amount from the file for an externally paid claim. |
|
|
| 8 |
PAID_CLM_FILE_PENALTY_AMT |
NUMERIC |
No |
|
|
|
| The total penalty amount from the file for an externally paid claim. |
|
|
| 9 |
BLK_DTA_MESSAGE_ID |
NUMERIC |
No |
|
|
|
| Contains the indexed AMS pointer to the last bulk data message record to impact this CLM. |
|
|
| 10 |
REFUND_REASON |
VARCHAR |
No |
|
|
|
| The refund reason for the claim. Will be used on any refund letters generated for the claim. |
|
|
| 11 |
PAYER_CLM_IDENT |
VARCHAR |
No |
|
|
|
| Stores the ID assigned to the claim from the payer. Currently in use for claims loaded through DINE. |
|
|
