|
Name |
Type |
Discontinued? |
|
1 |
CLAIM_PRINT_ID |
NUMERIC |
No |
|
|
|
The unique identifier for the Claim Info 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 |
ALL_CVG_ID |
NUMERIC |
No |
|
|
|
|
4 |
AUTH_NUM |
VARCHAR |
No |
|
|
|
Stores the authorization number for the corresponding coverage. |
|
|
5 |
AUTH_TYP_C_NAME |
VARCHAR |
No |
|
|
|
Store the authorization type for the corresponding coverage. |
May contain organization-specific values: No |
Category Entries: |
Referral Number |
Prior Authorization Number |
|
|
6 |
AUTH_SOURCE_REFERRAL_ID |
NUMERIC |
No |
|
|
|
The unique ID of the referral or auth/cert record when the authorization number on the row was found in the referral or auth/cert. |
|
|
7 |
AUTH_SOURCE_AUTH_ID |
NUMERIC |
No |
|
|
|
The unique ID of the service level authorization record when the authorization number on the row was found in the authorization record. |
|
|
8 |
AUTH_SOURCE_HSP_ACCOUNT_ID |
NUMERIC |
No |
|
|
|
The unique ID of the hospital account when the authorization number on the row was found in the account. |
|
|
9 |
AUTH_SOURCE_CLAIM_ID |
NUMERIC |
No |
|
|
|
The unique ID of the hospital account when the authorization number on the row was found in the account. |
|
|
10 |
AUTH_NUM_SOURCE_C_NAME |
VARCHAR |
No |
|
|
|
The auth number search precedence category ID identifying where the authorization number was found. |
May contain organization-specific values: No |
Category Entries: |
None |
Claim Info - Authorization Number (PB:CLM-341; HB:HAR-7053) |
Referral - Effective Coverages Authorization Number (RFL-18062) |
Referral - Default Authorization Number (RFL-60) |
Referral - Effective Coverages Pre-Certification Number (RFL-18064) |
Referral - Default Pre-Certification Number (RFL-18010) |
Episode Authorization Code |
Bed Days Table - Authorization Number (RFL-8513/8527) |
Dental Plan - Authorization Number (DTP-302) |
Referral - SAR/TAR (RFL-210/250/269) |
Referral - Service Level Auths (ETR-118; AUT-18062) |
|
|
11 |
AUTH_PB_RFL_RECORD_SOURCE_C_NAME |
VARCHAR |
No |
|
|
|
The Professional Billing referral source search precedence category ID identifying where the source referral or auth/cert record was found. |
May contain organization-specific values: No |
Category Entries: |
Referral assigned to the charge (ETR 116) |
Authorization assigned to the charge (AUT 105) |
Order associated with the charge (ORD 3300) |
Encounter associated with the charge (EPT 23015) |
|
|
12 |
AUTH_HB_RFL_RECORD_SOURCE_C_NAME |
VARCHAR |
No |
|
|
|
The Hospital Billing referral source search precedence category ID identifying where the source referral or auth/cert record was found. |
May contain organization-specific values: No |
Category Entries: |
Hospital account (HAR 130) |
Authorization assigned to the charge (AUT 105) |
Order associated with the charge (ORD 3300) |
Authorization associated with the encounter of the charge (EPT 23017) |
Technical referral associated with the encounter of the charge (EPT 23019) |
Primary referral associated with the encounter of the charge (EPT 23015) |
Authorization associated with the primary contact on the hospital account (EPT 23017) |
Technical referral associated with the primary contact on the hospital account (EPT 23019) |
Primary referral associated with the primary contact on the hospital account (EPT 23015) |
|
|
13 |
AUTH_SOURCE_TREATMENT_PLAN_ID |
VARCHAR |
No |
|
|
|
The unique ID of the dental treatment plan record when the authorization number on the row was found in the treatment plan. |
|
|