|
Name |
Type |
Discontinued? |
|
1 |
CLAIM_PRINT_ID |
NUMERIC |
No |
|
|
|
The ID of the claim record associated with a single hospital liability bucket. |
|
|
2 |
SA_ID_LOC_NAME |
VARCHAR |
No |
|
|
|
The name of the revenue location. |
|
|
3 |
INACTV_CLP_YN |
VARCHAR |
No |
|
|
|
This column has a value of yes when the claim is inactive. |
May contain organization-specific values: No |
Category Entries: |
No |
Yes |
|
|
4 |
CLAIM_ACCEPT_DTTM |
DATETIME (Local) |
No |
|
|
|
This column holds the instant the claim was accepted. |
|
|
5 |
SG_PAYOR_ID_PAYOR_NAME |
VARCHAR |
No |
|
|
|
|
6 |
SG_PLAN_ID_BENEFIT_PLAN_NAME |
VARCHAR |
No |
|
|
|
The name of the benefit plan record. |
|
|
7 |
SG_CVG_ID |
NUMERIC |
No |
|
|
|
The coverage ID for this claim. |
|
|
8 |
INVOICE_NUM |
VARCHAR |
No |
|
|
|
The invoice number for this claim. |
|
|
9 |
SG_PAT_ID |
VARCHAR |
No |
|
|
|
The patient ID for this claim. |
|
|
10 |
SG_GR_ACCT_ID |
NUMERIC |
No |
|
|
|
The guarantor account ID for this claim. |
|
|
11 |
HOSPITAL_ACCT_ID |
NUMERIC |
No |
|
|
|
The hospital account ID for this claim. |
|
|
12 |
HLB_ID |
NUMERIC |
No |
|
|
|
The liability bucket ID for this claim. |
|
|
13 |
SG_PROV_ID_PROV_NAME |
VARCHAR |
No |
|
|
|
The name of the service provider. This item may be hidden in a public view of the CLARITY_SER table. |
|
|
14 |
SG_REF_SRC_ID |
VARCHAR |
No |
|
|
|
The referring source ID for this claim. |
|
|
15 |
SG_REF_SRC_ID_REFERRING_PROV_NAM |
VARCHAR |
No |
|
|
|
The name of the referral source. |
|
|
16 |
SG_LOC_ID_LOC_NAME |
VARCHAR |
No |
|
|
|
The name of the revenue location. |
|
|
17 |
SG_DEP_ID_EXTERNAL_NAME |
VARCHAR |
No |
|
|
|
The external name of the department record. This is often used in patient correspondence such as reminder letters. |
|
|
18 |
SG_POS_ID_LOC_NAME |
VARCHAR |
No |
|
|
|
The name of the revenue location. |
|
|
19 |
SG_CLM_ID |
NUMERIC |
No |
|
|
|
The claim information ID used by this claim. |
|
|
20 |
SG_RQG_ID |
NUMERIC |
No |
|
|
|
The requisition grouper ID for this claim. |
|
|
21 |
CLAIM_CLASS_C_NAME |
VARCHAR |
No |
|
|
|
The account class used to evaluate this claim. |
May contain organization-specific values: Yes |
|
|
22 |
CLAIM_BASE_CLASS_C_NAME |
VARCHAR |
No |
|
|
|
The base account class used to evaluate this claim. |
May contain organization-specific values: No |
Category Entries: |
Inpatient |
Outpatient |
Emergency |
|
|
23 |
MIN_SERVICE_DT |
DATETIME |
No |
|
|
|
The minimum service date for this claim. |
|
|
24 |
MAX_SERVICE_DT |
DATETIME |
No |
|
|
|
The maximum service date for this claim. |
|
|
25 |
UB_FROM_DT |
DATETIME |
No |
|
|
|
The uniform billing claim from date. |
|
|
26 |
UB_THROUGH_DT |
DATETIME |
No |
|
|
|
The uniform billing claim through date. |
|
|
27 |
CLAIM_TYPE_C_NAME |
VARCHAR |
No |
|
|
|
The claim type. |
May contain organization-specific values: Yes |
Category Entries: |
CMS Claim |
UB Claim |
State Visit Data |
State Visit Provider Data |
Vektis Claim |
Pharmacy Claim |
|
|
28 |
CLAIM_FRM_TYPE_C_NAME |
VARCHAR |
No |
|
|
|
The form type. This is either paper or electronic. |
May contain organization-specific values: No |
Category Entries: |
Electronic Form |
Paper Form |
Both Paper and Electronic |
|
|
29 |
TTL_CHRGS_AMT |
NUMERIC |
No |
|
|
|
|
30 |
TTL_DUE_AMT |
VARCHAR |
No |
|
|
|
|
31 |
TTL_NONCVD_AMT |
NUMERIC |
No |
|
|
|
Total non-covered amount. |
|
|
32 |
TTL_PMT_AMT |
NUMERIC |
No |
|
|
|
|
33 |
TTL_ADJ_AMT |
NUMERIC |
No |
|
|
|
|
34 |
UB_BILL_TYPE |
VARCHAR |
No |
|
|
|
|
35 |
HM_HLTH_BILL_TYP_C_NAME |
VARCHAR |
No |
|
|
|
Home Health bill type. |
May contain organization-specific values: No |
Category Entries: |
Request for Anticipated Payment |
Home Health Claim |
Claim |
Cancel Request for Anticipated Payment |
Cancel Home Health Claim |
Home Health Claim Adjustment |
Hospice Election Claim |
Hospice Revocation Claim |
Cancel Hospice Election Claim |
Hospice Claim |
|
|
36 |
UB_SG_GRP_NUM |
VARCHAR |
No |
|
|
|
|
37 |
CNCL_CLAIM |
INTEGER |
No |
|
|
|
Indicates whether this is a cancel claim. |
|
|
38 |
REPL_CLAIM |
INTEGER |
No |
|
|
|
Indicates whether this is a replacement claim. |
|
|
39 |
UB_CVD_DAYS |
INTEGER |
No |
|
|
|
|
40 |
UB_COINS_DAYS |
INTEGER |
No |
|
|
|
|
41 |
UB_NON_CVD_DAYS |
INTEGER |
No |
|
|
|
|
42 |
UB_PRINC_DX_ID_DX_NAME |
VARCHAR |
No |
|
|
|
The name of the diagnosis. |
|
|
43 |
CNCL_CLAIM_CODE |
VARCHAR |
No |
|
|
|
The value code associated with this claim if it is a cancel claim. |
|
|
44 |
REPL_CLAIM_CODE |
VARCHAR |
No |
|
|
|
The value code associated with this claim if it is a replacement claim. |
|
|
45 |
SG_ALTPYR_CLM_YN |
VARCHAR |
No |
|
|
|
Flag used to indicate that claim is for alternate payer. |
The category values for this column were already listed for column: INACTV_CLP_YN |
|
|
46 |
FILING_ORDER_C_NAME |
VARCHAR |
No |
|
|
|
This column holds the filing order position of the claim coverage at the time claims were processed. |
May contain organization-specific values: No |
Category Entries: |
Primary |
Secondary |
Tertiary |
Post-Tertiary |
Unknown |
|
|
47 |
CLM_EXT_VAL_ID |
NUMERIC |
No |
|
|
|
The ID of the claim record. |
|
|
48 |
SG_TREAT_PLAN_ID |
VARCHAR |
No |
|
|
|
The unique ID of the treatment plan that is associated with the claim. |
|
|
49 |
UB_COMB_CLM_TYP_C_NAME |
VARCHAR |
No |
|
|
|
If this column is set to 1, the claim is a combined claim. |
May contain organization-specific values: Yes |
Category Entries: |
Normal claim (not combined) |
Combined claim |
|
|
50 |
REND_PROV_ID_PROV_NAME |
VARCHAR |
No |
|
|
|
The name of the service provider. This item may be hidden in a public view of the CLARITY_SER table. |
|
|
51 |
RESEARCH_ID_RESEARCH_STUDY_NAME |
VARCHAR |
No |
|
|
|
The name of the research study record. |
|
|
52 |
SRC_INV_NUM |
VARCHAR |
No |
|
|
|
In PB, this column holds the original invoice number during refresh and resubmit. In HB, this column holds the invoice number associated with the primary claim in a crossover scenario. |
|
|
53 |
CLAIM_TAX_AMOUNT |
NUMERIC |
No |
|
|
|
Gross tax amount at a claim level, this is the sum of all the tax amounts sent on a claim. |
|
|
54 |
DRG_XR_AMOUNT |
NUMERIC |
No |
|
|
|
The Diagnosis Related Group expected reimbursement amount. This will be stored for accounts billed with Diagnosis Related Group that need tax calculated specifically for the Diagnosis Related Group without any outliers or add-ons, as compared to the total expected reimbursement on the claim. |
|
|
55 |
DRG_TAX_AMOUNT |
NUMERIC |
No |
|
|
|
The Diagnosis Related Group tax amount. This will be stored for accounts billed with Diagnosis Related Group that have tax calculated based on expected reimbursement values. |
|
|
56 |
CLAIM_APEC_OUTLIER |
NUMERIC |
No |
|
|
|
This item stores the Adjudicated Payment per Episode of Care Outlier amount for a claim. |
|
|
57 |
SNF_CLAIM_TYPE_C_NAME |
VARCHAR |
No |
|
|
|
This item identifies the type of Skilled Nursing Facility claim produced. |
May contain organization-specific values: No |
Category Entries: |
Non-Managed SNF HAR |
Normal SNF HAR |
Partial Exhaust Before (Combined) |
Partial Exhaust Before (Separate) |
Partial Exhaust After (Insurance Bucket) |
Partial Exhaust After (Exhaust Bucket) |
Full Exhaust (Insurance Bucket) |
Full Exhaust (Exhaust Bucket) |
No-Payment (Insurance Bucket) |
No-Payment (No-Pay Bucket) |
|
|
58 |
DEPT_TYPE_C_NAME |
VARCHAR |
No |
|
|
|
The type of department. For Norway claims, this identifies the department as a GP Office, Trust, or Municipality. |
May contain organization-specific values: Yes |
No Entries Defined |
|
|
59 |
CLM_REBILL_REASON_C_NAME |
VARCHAR |
No |
|
|
|
This column stores the reason why we sent the claim again to payer. It holds onto the rebill reason with the highest precedence from the category list. |
May contain organization-specific values: No |
Category Entries: |
New claim |
Primary payer changed |
Secondary/Tertiary payer changed |
Payer's mailing address changed |
Subscriber ID changed |
Patient/Subscriber name changed |
Patient/Subscriber SSN changed |
Patient/Subscriber DOB changed |
Patient/Subscriber address changed |
Patient/Subscriber sex changed |
Encounter event date changed |
Account/Patient class changed |
Discharge status changed |
Combined accounts after billing |
Procedure changed |
DRG changed |
Diagnosis changed |
Late charges |
Cancel claim |
Referral/Auth number changed |
Other |
|
|
60 |
CLM_REBILL_USER_ID |
VARCHAR |
No |
|
|
|
This column stores the user who resubmitted the claim. |
|
|
61 |
CLM_REBILL_USER_ID_NAME |
VARCHAR |
No |
|
|
|
The name of the user record. This name may be hidden. |
|
|
62 |
FAC_ACTOR_TYPE_C_NAME |
VARCHAR |
No |
|
|
|
This item stores the type of facility. For Norway claims, this identifies the facility as a GP Office, Trust, or Municipality. |
May contain organization-specific values: No |
Category Entries: |
Trust |
Municipality |
General Practitioner |
|
|
63 |
BENEFIT_RECORD_ID |
NUMERIC |
No |
|
|
|
Stores the ID of the benefit (BEN) record used to calculate the patient responsibility. |
|
|
64 |
PREDICTED_PAY_DATE |
DATETIME |
No |
|
|
|
The predicted payment response date for a claim based on historical trends for the payer. |
|
|
65 |
SUGGESTED_FOL_UP_DATE |
DATETIME |
No |
|
|
|
The suggested initial follow-up date for a claim based on historical trends for the payer. |
|
|
66 |
CLM_CLOSED_TIMELY_YN |
VARCHAR |
No |
|
|
|
Denotes if the claim closed prior to its Suggested Initial Follow-up Date, whereby it was no longer outstanding to insurance. |
The category values for this column were already listed for column: INACTV_CLP_YN |
|
|