CLM_EDIT_WQ_CLM

Description:

This table contains the basic information pertaining to a claim in a claim edit workqueue. Rows for claims still in the error pool will be updated. Note that there are two date fields: EXTRACT_DATE indicates the most recent update where a claim was in the error pool. CLM_PROCESS_DATE indicates when the claim was originally processed and entered the error pool.

Primary Key

Column Name	Ordinal Position
CLP_ID	1

Column Information

	Name	Type	Discontinued?
1	CLP_ID	NUMERIC	No
	The ID of the claim record that entered the claim edit workqueue.
2	SERV_AREA_ID	NUMERIC	No
	The ID of the service area that appears on this claim.
3	LOC_ID	NUMERIC	No
	The ID of the location that appears on this claim.
4	PAYOR_ID	NUMERIC	No
	The ID of the payor that appears on this claim.
5	BENEFIT_PLAN_ID	NUMERIC	No
	The benefit plan ID that appears on this claim.
6	PROV_ID	VARCHAR	No
	The provider ID that appears on the claim.
7	COVERAGE_ID	NUMERIC	No
	The coverage ID that appears on the claim.
8	ACCOUNT_ID	NUMERIC	No
	The account ID that appears on the claim.
9	TOTAL_CHARGES	NUMERIC	No
	The dollar amount of charges on the claim.
10	TOTAL_PAYMENTS	NUMERIC	No
	The dollar amount in payments that appear on the claim. This applies to claims that have already had payments made on them.
11	INVOICE_ID	NUMERIC	No
	The ID of the invoice record associated with the claim.
12	INVOICE_NUMBER	VARCHAR	No
	The invoice number that appears on the claim. NOTE: This is not the same as the invoice ID.
13	POS_ID	NUMERIC	No
	The place of service for the claim.
14	PREDETERMINATION_YN	VARCHAR	No
	Stores a Yes/No indicator that the associated record represents a request for a predetermination of benefits. May contain organization-specific values: No Category Entries: No Yes
15	BILL_AREA_ID	NUMERIC	No
	Stores the Bill Area (BIL .1) associated with the claim.
16	BILL_AREA_ID_BILL_AREA_NAME	VARCHAR	No
	The record name of this bill area, financial subdivision, or financial division.
17	TOTAL_DUE	VARCHAR	No
	The total amount due on the claim.
18	TOTAL_INS_DUE	NUMERIC	No
	Stores the insurance amount due for the charges on the claim.
19	TOTAL_PAT_DUE	NUMERIC	No
	Stores the patient amount due for the charges on the claim.
20	TOTAL_NONCVD_AMT	NUMERIC	No
	Stores the total non-covered amount associated with the charges on the claim.
21	TOTAL_ADJ_AMT	NUMERIC	No
	Stores the total adjustment amount posted to the charges on the claim.