CL_RMT_CLM_INFO

Description:

This table contains the invoice level information to which the payment in the remittance record is posted.

Primary Key

Column Name	Ordinal Position
IMAGE_ID	1

Column Information

	Name	Type	Discontinued?
1	IMAGE_ID	VARCHAR	No
	This is the ID for the remittance image record.
2	INV_NO	VARCHAR	No
	The invoice number for the remittance image.
3	CLM_STAT_CD_C_NAME	VARCHAR	No
	This is the code identifying the status of an entire claim. May contain organization-specific values: No Category Entries: Processed as Primary Processed as Secondary Processed as Tertiary Denied Pended Received, but not in process Suspended Suspended-investigation with field Suspended-return with material Suspended-review pending Processed as Primary, Forwarded to additional Payer(s) Processed as Secondary, Forwarded to additional Payer(s) Processed as Tertiary, Forwarded to additional Payer(s) Reversal of previous payment Not Our Claim, Forwarded to additional Payer(s) Predetermination pricing only, No payment Reviewed
4	CLAIM_CHRG_AMT	NUMERIC	No
	This is the amount for submitted charges on this claim.
5	CLAIM_PAID_AMT	NUMERIC	No
	This is the amount paid on the claim.
6	PAT_RESP_AMT	NUMERIC	No
	This is the patient responsibility amount for the claim.
7	CLM_FILING_CODE_C_NAME	VARCHAR	No
	This is a code identifying the type of claim. May contain organization-specific values: No Category Entries: Preferred provider organization (PPO) Point of service (POS) Exclusive provider organization (EPO) Indemnity Insurance Health maintenance organization (HMO) medicare risk Automobile medical Tricare Disability Health maintenance organization Liability medical Medicare part A Medicare part B Medicaid Other federal program Title V Veteran administration plan Workers' compensation health claim Dental Maintenance Organization Champus Mutually Defined
8	ICN_NO	VARCHAR	No
	This is the payer's internal control number for the claim.
9	FAC_CODE_VAL	VARCHAR	No
	This is the facility code used when the submitted code has been modified through adjudication.
10	CLAIM_FREQ_C_NAME	VARCHAR	No
	This is the frequency code of the claim. May contain organization-specific values: No Category Entries: Non-Payment/Zero ORIGINAL CORRECTED REPLACEMENT VOID Late Charge(s) Only Interim - First Claim Interim - Continuing Claim Interim - Last Claim Final Claim for a Home Health PPS Episode Admission/Election Notice Hospice/Demonstration (CMS Coord, Centers of Ex, Prov Part)/Rel Non-Med Care Inst Hospice Change of Provider Notice Hospice/Demonstration (CMS Coord, Centers of Ex, Prov Part)/Rel Non-Med Care Inst V/C Hospice Change of Ownership Beneficiary Initiated Adjustment CWF Initiated Adjustment Claim CMS Initiated Adjustment Intermediary Adjustment Claim (Other than QIO or Provider) Initiated Adjustment Claim - Other OIG Initiated Adjustment Claim MSP Initiated Adjustment Claim Nonpayment/Zero Claims QIO Adjustment Claim Claim Submitted for Reconsideration Outside of Timely Limits Void/Cancel a Prior Abbreviated Encounter Submission Replacement of Prior Abbreviated Encounter Submission New Abbreviated Encounter Submission
11	DRG_CODE	VARCHAR	No
	This is the Diagnosis Related Group (DRG) code indicating a patient's diagnosis group based on a patient's illnesses, diseases, and medical problems.
12	DRG_WGT	NUMERIC	No
	The diagnosis related group weight.
13	DISCHRG_FRAC	NUMERIC	No
	The discharge fraction expressed as a decimal.
14	FILE_INV_NUM	VARCHAR	No
	Contains the actual invoice number that came in the file.