RECONCILE_CLM_OT
Description:
This table contains over time single information for claim reconciliation records.

Primary Key
Column Name Ordinal Position
CLAIM_REC_ID 1
CONTACT_DATE_REAL 2

Column Information
Name Type Discontinued?
1 CLAIM_REC_ID VARCHAR No
The unique ID of the claim reconciliation record.
2 CONTACT_DATE DATETIME No
The contact date of the claim, in external format.
3 CONTACT_DATE_REAL NUMERIC No
The contact date of the claim, in internal format.
4 CLM_STATUS_CODE_C_NAME VARCHAR No
The status code of the claim being tracked over time.
May contain organization-specific values: Yes
Category Entries:
Unmapped code received
5 PAYR_CLM_AMT_SUBMT NUMERIC No
The amount submitted by the payer on this claim.
6 PAYOR_CLM_AMT_PAID NUMERIC No
The amount paid by the payer on this claim.
7 PAYOR_REF_NUM VARCHAR No
The claim's payer reference number.
8 PAYOR_NAME VARCHAR No
The payer name of the payer on the claim.
9 CH_REF_NUM VARCHAR No
This is the claim's clearinghouse reference number.
10 CH_NAME VARCHAR No
This is the claim's clearinghouse name.
11 CLAIM_STATUS_MSG VARCHAR No
The claim's textual status message.
12 STATUS_DATE DATETIME No
The status date of the claim.
13 FILE_NAME VARCHAR No
This is the filename associated with this claim.
14 CM_CT_OWNER_ID VARCHAR No
ID of the deployment owner for this contact.
15 CLM_CLOSED_REASON_C_NAME VARCHAR No
The category value for the reason the claim was closed. This value can be used to link to the ZC_CLM_CLSD_REASON table to get more information on the category values.
May contain organization-specific values: No
Category Entries:
Payment
Posting Action
External Status Change
Bucket Closed
Bucket Rejected
Bucket Replaced
Bucket Reopened
Invoice Split During Refresh
16 CLAIM_ST_CAT_CODE_C_NAME VARCHAR No
The status category code of the claim being tracked over time.
May contain organization-specific values: Yes
Category Entries:
Unmapped code received
17 TRANSMIT_MEDIUM_C_NAME VARCHAR No
If claim has been transmitted, this item stores the medium.
May contain organization-specific values: Yes
Category Entries:
Paper
Electronic
18 ERR_FIELD VARCHAR No
The field a claim error is reported in.
19 ERR_ITEM VARCHAR No
The item for which the claim error was reported.
20 ERR_VAL VARCHAR No
The claim value that caused the error.
21 ERR_MSG VARCHAR No
The error message received for a claim.
22 CH_SENT_DATE DATETIME No
Stores the date that the claim was sent out of the clearinghouse.
23 PAYOR_RECV_DATE DATETIME No
Stores the date that the payer received the claim.
24 CLAIM_SEL_ACT_C_NAME VARCHAR No
Stores the action that was selected to be performed on the invoice.
May contain organization-specific values: No
Category Entries:
No Action
Accept Claim
Send to WQ
25 CLAIM_ACT_INFO_C_NAME VARCHAR No
Can store additional information on why a given action was selected.
May contain organization-specific values: No
Category Entries:
File payor does not match CLP payor
Billing system mismatch
Claim not on claim run
Claim run not in status of processed
Unable to lock CLP
No codes mapped to Send to WQ
26 TRANSMIT_STATUS_C_NAME VARCHAR No
Stores the system transmission status for the claim.
May contain organization-specific values: No
Category Entries:
Not Transmitted
Transmit Success
Transmit Failed
Retransmit Success
Retransmit Failed
Queued
27 EXTERNAL_REJECT_YN VARCHAR No
Yes/No flag indicating that the claim has been rejected by the payor or clearinghouse.
May contain organization-specific values: No
Category Entries:
No
Yes
28 PERFORM_ACT_C_NAME VARCHAR No
Will store the action that was performed on the invoice.
May contain organization-specific values: No
Category Entries:
No Action
Accept Claim from Run
Send to WQ from Run
Accept from WQ
Resubmit from WQ
Resend to WQ
External Test Response No Action Mapped
29 PERFORM_ACT_RSN VARCHAR No
Stores the reason for the action that was performed on the invoice.
30 GROUP_CONTROL_NUM INTEGER No
Stores the group control number (GS-06) value for an American National Standards Institute (ANSI) electronic claim file.
31 TRANSMIT_TYPE_C_NAME VARCHAR No
Records electronic claim transmission type.
May contain organization-specific values: No
Category Entries:
Automatic Transmission
CORE Transmission
32 PAYOR_CONTACT_NAME VARCHAR No
Name of contact person or department associated with an information request.
33 CLAIM_BILL_TYPE VARCHAR No
This is the bill type received in the claim reconciliation file.
34 MRN VARCHAR No
This is the medical record number (MRN) received in the claim reconciliation file.
35 INTERMEDIARY_IDENT VARCHAR No
This is the transmission identifier received in the claim reconciliation file.
36 AGENCY_CLAIM_NUM VARCHAR No
This is the claim number received in the claim reconciliation file.
37 CASE_REF_IDENT VARCHAR No
This is the case reference identifier received in the claim reconciliation file.
38 INFO_REQ_NUM VARCHAR No
This is the attachment request tracking number received in the claim reconciliation file.
39 PRIOR_INFO_REQ_NUM VARCHAR No
This is the prior attachment request tracking number received in the claim reconciliation file.
40 INFO_REQ_DUE_DATE DATETIME No
Stores the date the requested information is to be returned.
41 RESP_CONTACT_NAME VARCHAR No
Name used by the payer for routing the requested information within their system.
42 RESP_CONTACT_CITY VARCHAR No
City of the mailing location for the return of attachment data.
43 RESP_CONTACT_STATE VARCHAR No
State of the mailing location for the return of attachment data.
44 RESP_CONTACT_ZIP VARCHAR No
Postal Code of the mailing location for the return of attachment data.
45 RESP_CONTACT_CNTRY VARCHAR No
Country of the mailing location for the return of attachment data.
46 RESP_CONTACT_SUBDIV VARCHAR No
Subdivision of the mailing location for the return of attachment data.
47 SUPPORTED_ACTIONS_C_NAME VARCHAR No
The claim actions supported by the interface profile at the time a claim status update is received from an external entity.
May contain organization-specific values: No
Category Entries:
Accept Claim
Send to Workqueue
All Available Actions
48 TX_DEST_TYPE_C_NAME VARCHAR No
The destination type when the claim is transmitted.
May contain organization-specific values: No
Category Entries:
Payer
Clearinghouse
Other Entity
49 PAYER_CHECK_DATE DATETIME No
Holds the payer check date from claim reconciliation.
50 PAYER_CHECK_NUM VARCHAR No
Holds the payer check number from claim reconciliation.
51 STATUS_RESP_TYPE_C_NAME VARCHAR No
This type of status response this contact represents.
May contain organization-specific values: No
Category Entries:
Claim Acknowledgment
Claim Status Request Response
Claim Pending Status
Claim Request for Additional Information
Implementation Acknowledgment
Claim Payment/Advice
52 CLAIM_RECON_CSN_ID NUMERIC No
The contact serial number (CSN) of the contact.
53 HAS_REJ_SVC_LN_YN VARCHAR No
Yes/No flag indicating that the claim contains service lines that were rejected by the payer or clearinghouse.
The category values for this column were already listed for column: EXTERNAL_REJECT_YN
54 EXPRESS_IMAGE_ID VARCHAR No
This item is set with the invoice level IMD created from a payer's interface message data when responding to an Express claim.
55 MA_MAO002_ICN_IDENT VARCHAR No
The ICN received on the MAO-002 for Medicare Advantage encounter reporting.