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