HSP_CLAIM_DETAIL2
Description:
This table contains detailed claim print record information for claims associated with the hospital liability bucket.

Primary Key
Column Name Ordinal Position
CLAIM_PRINT_ID 1

Column Information
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 NUMERIC No
This column holds the service area for the claim.
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 NUMERIC No
The payer ID for this claim.
6 SG_PLAN_ID NUMERIC No
The plan ID for this claim.
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 VARCHAR No
The billing provider ID for this claim.
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 NUMERIC No
The location for this claim.
17 SG_DEP_ID NUMERIC No
The department ID for this claim.
18 SG_POS_ID NUMERIC No
The place of service ID for this claim.
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
Total charges amount.
30 TTL_DUE_AMT VARCHAR No
Total due amount.
31 TTL_NONCVD_AMT NUMERIC No
Total non-covered amount.
32 TTL_PMT_AMT NUMERIC No
Total payment amount.
33 TTL_ADJ_AMT NUMERIC No
Total adjustment amount.
34 UB_BILL_TYPE VARCHAR No
Type of bill.
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
Group number.
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
Covered days.
40 UB_COINS_DAYS INTEGER No
Coinsurance days.
41 UB_NON_CVD_DAYS INTEGER No
Non-covered days.
42 UB_PRINC_DX_ID NUMERIC No
Principal 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 VARCHAR No
This column holds the claim level rendering provider.
51 RESEARCH_ID VARCHAR No
This column holds the research study for the claim.
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