PMT_EOB_INFO_I

Description:

The PMT_EOB_INFO_I table contains the Explanation of Benefits information given a transaction ID. It contains data that is not multiple response given a transaction ID.

Primary Key

Column Name	Ordinal Position
TX_ID	1
LINE	2

Column Information

	Name	Type	Discontinued?
1	TX_ID	NUMERIC	No
	The unique identifier associated with the transaction for this row.
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	PEOB_TX_ID	NUMERIC	No
	The transaction ID of the matching charge.
4	CVD_AMT	NUMERIC	No
	The covered amount for that transaction.
5	NONCVD_AMT	NUMERIC	No
	The non-covered amount for that transaction.
6	DED_AMT	NUMERIC	No
	The deducted amount for that transaction.
7	COPAY_AMT	NUMERIC	No
	The copay amount for that transaction.
8	COINS_AMT	NUMERIC	No
	The coinsurance amount for that transaction.
9	COB_AMT	NUMERIC	No
	The Coordination of Benefits amount for that transaction.
10	PAID_AMT	NUMERIC	No
	The paid amount for that transaction.
11	ICN	VARCHAR	No
	The internal control number for that transaction.
12	DENIAL_CODES	VARCHAR	No
	The denial code for the transaction.
13	PEOB_ACTION_NAME_C_NAME	VARCHAR	No
	The Explanation Of Benefits action category ID for the transaction. May contain organization-specific values: No Category Entries: Next Responsible Party Resubmit Insurance
14	ACTION_AMT	NUMERIC	No
	The action amount for this transaction.
15	ACCOUNT_ID	NUMERIC	No
	The Account Id of the transfer to self-pay action or next responsible party to self-pay action performed in insurance payment posting.
16	COVERAGE_ID	NUMERIC	No
	The Action Coverage of the next responsible party action or resubmit insurance action performed in insurance payment posting.
17	ACTION_ASN_NAME_C_NAME	VARCHAR	No
	The action assignment category ID for the transaction. May contain organization-specific values: No Category Entries: Yes No Yes, No Claim No, Submit Claim Yes, Cross Over
18	COMMENTS	VARCHAR	No
	The comments associated the Explanation of Benefits for a transaction.
19	INFO_LINES	VARCHAR	No
	The info lines in PMT_EOB_INFO_II.
20	WIN_DENIAL_ID	VARCHAR	No
	The winning denial remittance code.
21	WIN_DENIAL_ID_REMIT_CODE_NAME	VARCHAR	No
	The name of each remittance code.
22	ACTION_EOB	VARCHAR	No
	The Explanation of Benefits code for actions (next responsible party or resubmit) in payment posting associated with the transaction.
23	INVOICE_NUM	VARCHAR	No
	The invoice number for the transaction.
24	SUMMARY	VARCHAR	No
	Contains any paid, adjustment, copay, coinsurance, or allowed amount for a transaction.
25	TX_MATCH_DATE	DATETIME	No
	The date when the charge was matched to the payment.
26	CROSSOVER_C_NAME	VARCHAR	No
	Indicates the crossover scenario of this payment transaction at the time of payment posting. The crossover scenario value describes whether this payment transaction is a regular payment, a primary payment (and whether or not the crossover payor has paid), or a crossover payment (and whether or not the primary payor has paid). May contain organization-specific values: No Category Entries: Regular Payment Primary payment, crossover not paid yet Crossover payment, primary already paid Crossover payment, primary not paid yet Primary payment, crossover already paid
27	NON_PRIMARY_SYS_YN	VARCHAR	No
	Indicates whether the system determines this payment transaction as a non-primary payment at the time of payment posting based on crossover information, invoice information, and previous payments information. Y indicates the system determines this payment transaction as a non-primary payment at the time of payment posting based on crossover information, invoice information, and previous payments information. A null value indicates the system does not determine this payment transaction as a non-primary payment at the time of payment posting based on crossover information, invoice information, and previous payments information. May contain organization-specific values: No Category Entries: No Yes
28	NON_PRIMARY_USR_YN	VARCHAR	No
	Indicates whether the user determines this payment transaction as a non-primary payment at the time of payment posting. The value of the Non-primary posting (user) is usually the same as the system determined non-primary posting value. However, users can override the system determined non-primary posting value based on the EOB information. Y indicates the user determines this payment transaction as a non-primary payment at the time of payment posting. The category values for this column were already listed for column: NON_PRIMARY_SYS_YN
29	PEOB_ACTION_C_NAME	VARCHAR	No
	Indicates the Next Responsible Party, Resubmit Insurance or Transfer to Self-Pay action taken on the charge. May contain organization-specific values: No Category Entries: Next Responsible Party Resubmit Insurance Transfer to Self-Pay
30	INV_ID	NUMERIC	No
	Invoice ID that is associated with one payment Explanation of Benefits line. Use this field along with INV_LINE to link to the proper record in the INV_CLM_LN_ADDL table.
31	INV_LINE	INTEGER	No
	Line count of one invoice record for internal calculation use. It is different from claim form line. Use this field along with INV_ID to link to the associated record in the INV_CLM_LN_ADDL table.
32	NO_MATCHED_CHGS_YN	VARCHAR	No
	This column is set to Y when all charges associated with this EOB line have been unmatched from the payment.
33	PEOB_ACCOUNT_ID	NUMERIC	No
	The ID of the guarantor on the invoice associated with the payment. If there is no associated invoice, this column stores the ID of the guarantor from the charge.
34	PEOB_LOC_ID_LOC_NAME	VARCHAR	No
	The name of the revenue location.
35	PEOB_POS_ID_LOC_NAME	VARCHAR	No
	The name of the revenue location.
36	PEOB_DEPT_ID_EXTERNAL_NAME	VARCHAR	No
	The external name of the department record. This is often used in patient correspondence such as reminder letters.
37	PEOB_BILL_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.
38	PEOB_PLAN_ID_BENEFIT_PLAN_NAME	VARCHAR	No
	The name of the benefit plan record.
39	PEOB_PROC_ID_PROC_NAME	VARCHAR	No
	The name of each procedure.
40	PEOB_MTCH_CHG_TX_ID	NUMERIC	No
	The ID of the first matching charge transaction on the invoice associated with the payment. If there is no associated invoice, this column stores the ID of the charge from the Explanation of Benefits master file.