CLAIM_REFERENCE_DATA
Description:
Table of Claim Reference Data collections, where each collection represents a single piece of received claim-related data.

Primary Key
Column Name Ordinal Position
REF_DATA_ID 1

Column Information
Name Type Discontinued?
1 REF_DATA_ID NUMERIC No
The unique identifier for the Claim Reference Data record.
2 RECORD_STATUS_C_NAME VARCHAR No
Stores the record status (hidden, soft-deleted, and others).
May contain organization-specific values: No
Category Entries:
Soft Deleted
Hidden
Hidden and Soft Deleted
3 ORGANIZATION_ID NUMERIC No
The ID of the organization that sent the invoice.
4 ORGANIZATION_ID_EXTERNAL_NAME VARCHAR No
Organization's external name used as the display name on forms and user interfaces.
5 PAT_ID VARCHAR No
The Patient ID of the member in the Payer system for whom the invoice was sent.
6 MEMBER_IDENT VARCHAR No
The Member ID of the associated member for whom the invoice was sent.
7 CRF_RECORD_TYPE_C_NAME VARCHAR No
The type of Claim Reference Data record. This is determined by the claims-related record the Claim Reference Data record will link to (Claim, Referal, or other).
May contain organization-specific values: No
Category Entries:
Claim
8 LINKED_CLAIM_ID NUMERIC No
The ID of the Claim record linked to the Claim Reference Data record.
9 BILLING_PROV_NPI VARCHAR No
The NPI of the Billing Provider / Vendor that sent the invoice.
10 BILLING_PROV_TAX_IDENT VARCHAR No
The Tax ID of the Billing Provider / Vendor that sent the invoice.
11 BILLING_SYS_C_NAME VARCHAR No
The type of the Billing System that sent the invoice.
May contain organization-specific values: No
Category Entries:
Professional Billing
Hospital Billing
Tapestry
Healthy Planet
Payer Platform
Data Aggregation
12 HOSPITAL_ACCT_IDENT VARCHAR No
The external identifier of the Hospital Account associated with the invoice. This identifier should not be used to join to internal Hospital Account tables.
13 CLAIM_INT_CONTROL_NUMBER VARCHAR No
The Internal Control Number (ICN) for the claim. Each ICN points to a unique Claim record in the Payer system.
14 INVOICE_NUMBER VARCHAR No
The number of the invoice in the claim reference data set.
15 CLAIM_FROM_DATE DATETIME No
The minimum service date on the claim.
16 CLAIM_TO_DATE DATETIME No
The maximum service date on the claim.
17 BILLED_AMOUNT NUMERIC No
The total of the charges on the claim.
18 ORIGINAL_INVOICE_NUMBER VARCHAR No
The number of the original or previous invoice in a series of invoices where the previous invoice was canceled, replaced, resubmitted, or otherwise nullified.
19 CANCEL_FLAG_C_NAME VARCHAR No
Flag raised if the associated invoice is a Cancellation.
May contain organization-specific values: No
Category Entries:
Yes
20 REPLACE_FLAG_C_NAME VARCHAR No
Flag raised if the associated invoice is a Replacement.
The category values for this column were already listed for column: CANCEL_FLAG_C_NAME
21 RESUBMIT_FLAG_C_NAME VARCHAR No
Flag raised if the associated invoice is a Resubmission.
The category values for this column were already listed for column: CANCEL_FLAG_C_NAME
22 RECORD_NAME VARCHAR No
The name of the Claim Reference Data record.
23 PRIMARY_LINK_UTC_DTTM DATETIME (UTC) No
The instant a Primary record was linked to the Claim Reference Data record.
24 CANCELLED_BY_PROV_FLAG_C_NAME VARCHAR No
Indicates whether the associated invoice has been cancelled by the submitter.
The category values for this column were already listed for column: CANCEL_FLAG_C_NAME
25 PAT_MRN VARCHAR No
The patient's medical record number.
26 FILING_ORDER_C_NAME VARCHAR No
Stores the providers claim filing order.
May contain organization-specific values: No
Category Entries:
Primary
Secondary
Tertiary
Post-Tertiary
Unknown
27 REF_DATA_CLAIM_PRINT_ID NUMERIC No
The claim print record for which the CRF record is generated from. This item is only populated on a shared instance implementation of CRF.
28 ASSOCIATED_CLAIM_FORM_TYPE_C_NAME VARCHAR No
The claim type associated with this Claim Reference Data record.
May contain organization-specific values: Yes
Category Entries:
CMS Claim
UB Claim
State Visit Data
State Visit Provider Data
Vektis Claim
Pharmacy Claim
29 ASSOCIATED_COVERAGE_ID NUMERIC No
The coverage associated with this Claim Reference Data record.
30 PROV_CLM_RECON VARCHAR No
The Claim Reconciliation (CRD) record id in the provider system's Epic instance. This is not a networked item and does not link to a Claim Reconciliation record.
31 SUBSCRIBER_IDENT VARCHAR No
The Subscriber ID of the member in the Payer system associated with the claim reference data set.
32 MEM_REL_TO_SUB_C_NAME VARCHAR No
The relationship of the patient to the subscriber for the member in the Payer system associated with the claim reference data set.
May contain organization-specific values: Yes
Category Entries:
Self
Spouse
Child
Employee
Unknown