Data SnapShot - Activity

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) Foreign key to SEQNO from Claim.

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. Foreign key to PACCTNO from Patient.

Numeric - 8 or 9 digits

PAYOR

The payer that the claim was billed to.
(Only applicable to rows associated with claim activity) Foreign key to SEQNO from Payer.

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

RENDERING


For claim activity, the provider who rendered the services on the claim at the time it was billed. For statement activity, this is the provider associated with the latest charge on the statement. Foreign key to SEQNO from Provider.

Numeric - 8 digits

RDATE

The latest date that electronic remittance advice was received for this claim submission.
(Only applicable to rows associated with claim activity)

Date/Time

RSTATUS

The  latest payer action from the last electronic remittance advice received for this 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 (paper or electronic)
  • T: Plain text user printed statement
  • U: Enhanced user printed statement
  • M: Manual electronic statement