|
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 |
|
|