Data SnapShot - Activity
Last Modified on 10/23/2024 12:57 pm EDT
Scope The site documents the data tables pertaining to a custom data snapshot requested by a customer for their account. The requested data snapshot is inclusive of all your data excluding document imaging. Please note that while the data from all of your reports will be included within the snapshot, your actual standard and custom report templates will not be included. Each data snapshot is exported in Tab Delimited (.DAT) data file format or a MySQL database, as specified in your original data snapshot request. The data snapshot can be downloaded using the instructions sent to you within the secure message.
The table below denotes the names of the files along with a file description associated with your custom data snapshot. You can click on any of the applicable links below to review the description of the pertinent data fields within each file for processing the data within the snapshot.
Activity
Unlike many of the other files included in a Data Snapshot, the
Activity file holds information related to
two sets of records:
- Claim billing activity
- Patient statement activity
Because both of these sets of information are included in the same file, it is essential to use the TRANTYPE column to distinguish the records related to
billed claims from the records related to
patient statements.
Field | Description | Values |
TRANID
| Unique identifier for each activity line.
| Numeric - 8 or 9 digits
|
CLAIMID
| The ID of the claim that was billed.
(Only applicable to rows associated with claim activity)
| Numeric - 8 digits
|
ENTERED
| The date/time that the claim/statement activity occurred.
| Date/Time
|
FROMDATE
| The from date (DOS) of the claim that was billed.
(Only applicable to rows associated with claim activity)
| Date
|
PATIENT
| The patient account number associated with the claim/statement.
| Numeric - 8 digits
|
PAYOR
| The payer that the claim was billed to.
(Only applicable to rows associated with claim activity)
| Numeric - 8 digits
|
PDATE
| The date that the most recent claim processing status was received by the Clearinghouse.
(Only applicable to rows associated with claim activity)
| Date/Time
|
PSTATUS
| The most recent status code returned by the Clearinghouse for the submitted claim.
(Only applicable to rows associated with claim activity)
| Character
(See Claim Tracking for code meanings)
|
PTYPE
| Represents whether or not a claim was successfully submitted to the clearinghouse.
(Only applicable to rows associated with claim activity)
| A: Accepted
X: Unprocessed
E: Error
B: Sent on paper from Clearinghouse
|
RDATE
| The date that the payer action was received for the submitted claim.
(Only applicable to rows associated with claim activity)
| Date/Time
|
RSTATUS
| The payer action resulting from the claim submission.
(Only applicable to rows associated with claim activity)
| 1: Processed as Primary
2: Processed as Secondary
3: Processed as Tertiary
4: Denied
19: Processed as Primary, Forwarded to Additional Payer(s)
20: Processed as Secondary, Forwarded to Additional Payer(s)
21: Processed as Tertiary, Forwarded to Additional Payer(s)
22: Reversal of Previous Payment
23: Not Our Claim, Forwarded to Additional Payer(s)
25: Predetermination Pricing Only - No Payment
|
TOTAMT
| Claim activity - The amount of the claim that was billed.
Statement activity - The amount of the statement that was sent.
| Monetary
|
TRANTYPE
| Distinguishes the type of activity that a row represents.
| Claim Activity - E: Clearinghouse sent electronically
- F: Clearinghouse sent on paper
- P: User printed claim
Statement Activity
- S: Automated statement
- T: Plain text user printed statement
- U: Enhanced user printed statement
|