Data SnapShot - Charge

Charge

Denoted below are the specific Charge and Debit (claim line item) data items and their associated data types to assist with processing a data snapshot.


Field

Description

Values

TRANID

Unique identifier for the charge/debit

Numeric - 8 or 9 digits

AMOUNT

The amount (Unit Price multiplied by Units) of the charge/debit.

Monetary

BALANCE

The balance (how much is still owed) of the charge/debit.

Monetary

BILLTO

The current status of the charge or debit

0: On Hold
1: Send to Insurance via Clearinghouse
2: Claim at Insurance
3: Balance Due Patient
5: Paid
6: Incomplete
7: User Print and Mail to Insurance
A: Deleted
C: Pending Insurance
D: Collection
E: Pending Patient
F: Appeal at Insurance
G: Waiting for Review
H: Denied at Insurance
J: Pending Physician
L: Rejected at Clearinghouse

CLAIMID

The claim # the charge/debit is associated with.

Note: Account debits not associated with any particular claim will have '10000000' in this field.

Numeric - 8 digits

CLAIMLOC

The ID of the payer that the charge is currently being billed to.

Numeric - 8 digits

DELETED

Whether the charge/debit has been deleted

0: Not deleted
1: Deleted

DRUG_CODE_FORMAT

Drug Code Format

N1: 4-4-2
N2: 5-3-2
N3: 5-4-1
N4: 5-4-2
EN: EAN/UCC - 13
EO: EAN/UCC - 8
HI: HIBC Supplier Labeling Standard Primary Data Message
ON: Customer Order Number
UK: GTIN 14-digit Data Structure
UP: UCC-12

DRUGMEASURE

Drug Measurement Units

0: Unit (UN)
1: Gram (GR)
2: Milliliter (ML)
3: International (F2
4: Milligram (ME)

ELECTRONIC

The unit price of the charge/debit.

Monetary

ENTERED

The date/time that the charge/debit was entered into the system.

Date/Time

FROMDATE

The "From" date of service of the charge/debit.

Date

MOD1

The first modifier on the charge (M1).

Alphanumeric - Up to 2 characters

MOD2

The second modifier on the charge (M2).

Alphanumeric - Up to 2 characters

MOD3

The third modifier on the charge (M3).

Alphanumeric - Up to 2 characters

MOD4

The fourth modifier on the charge (M4).

Alphanumeric - Up to 2 characters

PAYOR1

The ID of the primary payer set on the charge's claim.
(This is not necessarily the payer that the charge was billed to. See CLAIMLOC for the charge's current payer)

Numeric - 8 digits

PAYOR2

The ID of the secondary payer set on the charge's claim.
(This is not necessarily the payer that the charge was billed to. See CLAIMLOC for the charge's current payer)

Numeric - 8 digits

PAYOR3

The ID of the tertiary payer set on the charge's claim.
(This is not necessarily the payer that the charge was billed to. See CLAIMLOC for the charge's current payer)

Numeric - 8 digits

TODATE

The "To" date of service of the charge/debit.

Date