|
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. |
|
|