|
Name |
Type |
Discontinued? |
|
1 |
REFERRAL_ID |
NUMERIC |
No |
|
|
|
The referral ID for the referral record. |
|
|
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 |
AUTH_CERT_CVG_ID |
NUMERIC |
No |
|
|
|
Coverage ID for Auth/Cert information |
|
|
4 |
PRE_CERT_REQ_YN |
VARCHAR |
No |
|
|
|
Indicates whether pre-cert is required for this coverage |
May contain organization-specific values: No |
Category Entries: |
Yes |
No |
|
|
5 |
PRE_CERT_STATUS_C_NAME |
VARCHAR |
No |
|
|
|
Pre-certification status for this coverage |
May contain organization-specific values: Yes |
|
|
6 |
PRE_CERT_AGENCY_ID |
VARCHAR |
No |
|
|
|
ID of the agency used for precertification |
|
|
7 |
PRE_CERT_AGENCY_ID_AGENCY_NAME |
VARCHAR |
No |
|
|
|
|
8 |
PRE_CERT_AGENCY_PH |
VARCHAR |
No |
|
|
|
Phone number of the agency used for precertification |
|
|
9 |
PRE_CERT_CONTACT |
VARCHAR |
No |
|
|
|
Contact individual for the pre-certification agency |
|
|
10 |
PRE_CERT_CALLED_DT |
DATETIME |
No |
|
|
|
Date on which the payor was called for pre-certification information |
|
|
11 |
PRE_CERT_RECV_DT |
DATETIME |
No |
|
|
|
Date on which pre-certification information was received |
|
|
12 |
PRE_CERT_RCV_ID |
VARCHAR |
No |
|
|
|
User who received pre-certification information |
|
|
13 |
PRE_CERT_RCV_ID_NAME |
VARCHAR |
No |
|
|
|
The name of the user record. This name may be hidden. |
|
|
14 |
PRE_CERT_FAX |
VARCHAR |
No |
|
|
|
Fax number for pre-certification information |
|
|
15 |
PRE_CERT_BN_REQ_YN |
VARCHAR |
No |
|
|
|
Indicates whether a pre-certification benefits check is required |
The category values for this column were already listed for column: PRE_CERT_REQ_YN |
|
|
16 |
PRE_CERT_BEN_STS_C_NAME |
VARCHAR |
No |
|
|
|
Status of the pre-certification benefits |
May contain organization-specific values: Yes |
|
|
17 |
PRE_CERT_BEN_CHECK |
VARCHAR |
No |
|
|
|
Individual from whom pre-cert benefits information was received |
|
|
18 |
PRE_CERT_BEN_PHONE |
VARCHAR |
No |
|
|
|
Phone number to use for pre-cert benefits checking |
|
|
19 |
PRE_CERT_BEN_CNCT |
VARCHAR |
No |
|
|
|
Contact person for pre-cert benefits checking |
|
|
20 |
PRE_CERT_BEN_FAX |
VARCHAR |
No |
|
|
|
Fax number for pre-cert benefits checking |
|
|
21 |
PRE_CERT_BEN_CK_DT |
DATETIME |
No |
|
|
|
Date on which pre-cert benefits were checked |
|
|
22 |
PRE_CERT_BN_USR_ID |
VARCHAR |
No |
|
|
|
ID of user who checked pre-cert benefits information |
|
|
23 |
PRE_CERT_BN_USR_ID_NAME |
VARCHAR |
No |
|
|
|
The name of the user record. This name may be hidden. |
|
|
24 |
PRE_CERT_CLIN_CNCT |
VARCHAR |
No |
|
|
|
Contact individual for pre-cert clinical information |
|
|
25 |
PRE_CERT_CLIN_PHON |
VARCHAR |
No |
|
|
|
Phone number for pre-cert clinical information |
|
|
26 |
AUTH_FROM_DT |
DATETIME |
No |
|
|
|
The beginning date of the period authorized by the payor |
|
|
27 |
AUTH_TO_DT |
DATETIME |
No |
|
|
|
The end date of the period authorized by the payor. |
|
|
28 |
MAX_OUT_POCKET |
NUMERIC |
No |
|
|
|
Contains Maximum Out of Pocket Amount: The most you pay in coinsurance during a benefit plan year. After you reach your out-of-pocket maximum, your medical plan option pays 100% (unless balance billing applies) of eligible expenses for the remainder of the benefit plan year |
|
|
29 |
LIFETIME_MAX |
NUMERIC |
No |
|
|
|
Contains Lifetime Maximum Amount: The maximum amount that the insurance company will cover for this patient over the course of their lifetime. |
|
|
30 |
TOT_PT_AMOUNT |
NUMERIC |
No |
|
|
|
Contains Total Patient Amount: The total amount the patient owes for this visit |
|
|
31 |
ADM_NOTIF_STAT_C_NAME |
VARCHAR |
No |
|
|
|
Contains admission notification status: A field that can be used to track the status of the admission notification that needs to be faxed or sent electronically to the payor. This is a customer-owned category list. |
May contain organization-specific values: Yes |
|
|
32 |
CONC_REV_REQD_YN |
VARCHAR |
No |
|
|
|
Contains Information on whether a concurrent review (clinical review) is required or not. |
May contain organization-specific values: No |
Category Entries: |
No |
Yes |
|
|
33 |
IN_NETWORK_YN |
VARCHAR |
No |
|
|
|
This field is used to track whether or not the patient’s insurance is in Network. |
The category values for this column were already listed for column: CONC_REV_REQD_YN |
|
|
34 |
DEDUCTIBLE_MET_YN |
VARCHAR |
No |
|
|
|
A deductible is the amount you must pay before the Plan begins to pay benefits. This field tracks whether or not the patient has paid that amount. |
The category values for this column were already listed for column: CONC_REV_REQD_YN |
|
|
35 |
DEDUCTIBLE_MET_AMT |
NUMERIC |
No |
|
|
|
Contains Deductible Met Amount. A deductible is the amount you must pay before the Plan begins to pay benefits. This field tracks how much the patient has paid. |
|
|
36 |
COINSUR_MET_YN |
VARCHAR |
No |
|
|
|
Coinsurance is a percentage of an eligible expense that you are required to pay for a covered service. This field tracks whether or not the patient has paid that amount. |
The category values for this column were already listed for column: CONC_REV_REQD_YN |
|
|
37 |
COINSURANCE_MET_AMT |
NUMERIC |
No |
|
|
|
Contains coinsurance met amount. Coinsurance is a percentage of an eligible expense that you are required to pay for a covered service. This field tracks how much the patient has paid. |
|
|
38 |
OUT_POCKET_MET_YN |
VARCHAR |
No |
|
|
|
This fields tracks whether or not the patient has paid their out of pocket expenses. |
The category values for this column were already listed for column: CONC_REV_REQD_YN |
|
|
39 |
OUT_POCKET_MET_AMT |
NUMERIC |
No |
|
|
|
Contains Out of Pocket Met Amount. This fields tracks how much the patient has paid towards their out of pocket expenses. |
|
|
40 |
PREEXIST_COND_YN |
VARCHAR |
No |
|
|
|
Contains whether or not pre-existing conditions are present. It is used to track whether or not the patient has pre-existing conditions that may impact their benefits. |
The category values for this column were already listed for column: CONC_REV_REQD_YN |
|
|
41 |
PREEXIST_COND_VAL |
VARCHAR |
No |
|
|
|
Contains Pre-existing conditions value. If the patient has pre-existing conditions that may impact their benefits, this field is used to document the pre-existing conditions. |
|
|
42 |
PRECERT_CMT_NOTE_ID |
VARCHAR |
No |
|
|
|
The unique ID of the note containing pre-certification comments entered on the referral. |
|
|
43 |
PRECERT_BEN_NOTE_ID |
VARCHAR |
No |
|
|
|
The unique ID of the note containing benefits information entered on the referral. |
|
|
44 |
GENERIC_CATEG_1_C_NAME |
VARCHAR |
No |
|
|
|
Generic category for general use |
May contain organization-specific values: Yes |
No Entries Defined |
|
|
45 |
GENERIC_CATEG_2_C_NAME |
VARCHAR |
No |
|
|
|
Generic category for general use |
May contain organization-specific values: Yes |
No Entries Defined |
|
|
46 |
GENERIC_CATEG_3_C_NAME |
VARCHAR |
No |
|
|
|
Generic category for general use |
May contain organization-specific values: Yes |
No Entries Defined |
|
|
47 |
GENERIC_CATEG_4_C_NAME |
VARCHAR |
No |
|
|
|
Generic category for general use |
May contain organization-specific values: Yes |
No Entries Defined |
|
|
48 |
GENERIC_CATEG_5_C_NAME |
VARCHAR |
No |
|
|
|
Generic category for general use |
May contain organization-specific values: Yes |
No Entries Defined |
|
|
49 |
GENERIC_CATEG_6_C_NAME |
VARCHAR |
No |
|
|
|
Generic category for general use |
May contain organization-specific values: Yes |
No Entries Defined |
|
|
50 |
GENERIC_CATEG_7_C_NAME |
VARCHAR |
No |
|
|
|
Generic category for general use |
May contain organization-specific values: Yes |
No Entries Defined |
|
|
51 |
GENERIC_CATEG_8_C_NAME |
VARCHAR |
No |
|
|
|
Generic category for general use |
May contain organization-specific values: Yes |
No Entries Defined |
|
|
52 |
GENERIC_CATEG_9_C_NAME |
VARCHAR |
No |
|
|
|
Generic category for general use |
May contain organization-specific values: Yes |
No Entries Defined |
|
|
53 |
GENERIC_CATG_10_C_NAME |
VARCHAR |
No |
|
|
|
Generic category for general use |
May contain organization-specific values: Yes |
No Entries Defined |
|
|
54 |
GENERIC_STR_1 |
VARCHAR |
No |
|
|
|
Generic string item for general use |
|
|
55 |
GENERIC_STR_2 |
VARCHAR |
No |
|
|
|
Generic string item for general use |
|
|
56 |
GENERIC_STR_3 |
VARCHAR |
No |
|
|
|
Generic string item for general use |
|
|
57 |
GENERIC_STR_4 |
VARCHAR |
No |
|
|
|
Generic string item for general use |
|
|
58 |
GENERIC_STR_5 |
VARCHAR |
No |
|
|
|
Generic string item for general use |
|
|
59 |
GENERIC_NUM_IT_1 |
NUMERIC |
No |
|
|
|
Generic numeric item for general use |
|
|
60 |
GENERIC_NUM_IT_2 |
NUMERIC |
No |
|
|
|
Generic numeric item for general use |
|
|
61 |
GENERIC_NUM_IT_3 |
NUMERIC |
No |
|
|
|
Generic numeric item for general use |
|
|
62 |
GENERIC_NUM_IT_4 |
NUMERIC |
No |
|
|
|
Generic numeric item for general use |
|
|
63 |
GENERIC_NUM_IT_5 |
NUMERIC |
No |
|
|
|
Generic numeric item for general use |
|
|
64 |
GENERIC_NUM_IT_6 |
NUMERIC |
No |
|
|
|
Generic numeric item for general use |
|
|
65 |
GENERIC_NUM_IT_7 |
NUMERIC |
No |
|
|
|
Generic numeric item for general use |
|
|
66 |
GENERIC_NUM_IT_8 |
NUMERIC |
No |
|
|
|
Generic numeric item for general use |
|
|
67 |
GENERIC_NUM_IT_9 |
NUMERIC |
No |
|
|
|
Generic numeric item for general use |
|
|
68 |
GENERIC_NUM_IT_10 |
NUMERIC |
No |
|
|
|
Generic numeric item for general use |
|
|
69 |
GENERIC_DATE_1_DATE |
DATETIME |
No |
|
|
|
Generic date item for general use |
|
|
70 |
GENERIC_DATE_2_DATE |
DATETIME |
No |
|
|
|
Generic date item for general use |
|
|
71 |
GENERIC_DATE_3_DATE |
DATETIME |
No |
|
|
|
Generic date item for general use |
|
|
72 |
GENERIC_DATE_4_DATE |
DATETIME |
No |
|
|
|
Generic date item for general use |
|
|
73 |
GENERIC_DATE_5_DATE |
DATETIME |
No |
|
|
|
Generic date item for general use |
|
|
74 |
GENERIC_SEC_SINCE_MIDNIGHT_1 |
NUMERIC |
No |
|
|
|
Generic time item for general use |
|
|
75 |
GENERIC_SEC_SINCE_MIDNIGHT_2 |
NUMERIC |
No |
|
|
|
Generic time item for general use |
|
|
76 |
GENERIC_SEC_SINCE_MIDNIGHT_3 |
NUMERIC |
No |
|
|
|
Generic time item for general use |
|
|
77 |
GENERIC_SEC_SINCE_MIDNIGHT_4 |
NUMERIC |
No |
|
|
|
Generic time item for general use |
|
|
78 |
GENERIC_SEC_SINCE_MIDNIGHT_5 |
NUMERIC |
No |
|
|
|
Generic time item for general use |
|
|