Data SnapShot - Claim

Claim

Denoted below are the specific Claim data items and their associated data types to assist with processing a data snapshot.


Field

Description

Values

SEQNO

Unique identifier for the claim.

Numeric - 8 or 9 digits

AUTHNO1

The primary insurance Authorization # set on the claim.

Alphanumeric - Up to 30 characters

AUTHNO2

The secondary insurance Authorization # set on the claim.

Alphanumeric - Up to 30 characters

AUTHNO3

The tertiary insurance Authorization # set on the claim.

Alphanumeric - Up to 30 characters

BILLPROV

The ID of the billing provider set on the claim.  Foreign key to the SEQNO column in Provider.

Numeric - 8 digits

BILLTO

The current status of the claim

For Default (BILLTO) Charge Statuses visit our Default Charge Statuses Help Article 

BOX10D

The Claim Codes set on the claim.

Alphanumeric - Up to 20 characters

BOX11B

The Other Claim ID set on the claim.

Alphanumeric - Up to 28 characters

BOX19

The Additional Claim Information set on the claim.

Alphanumeric - Up to 83 characters

CLAIMLOC


The ID of the payer that the claim's status is currently associated to. Foreign key to the SEQNO column in Payer (not applicable for claimloc '0')
Numeric - 8 digits

CLAIM_NOTE

The Claim Note set on the claim.
(This deals with the field under the Additional Info tab, not with patient notes added to claims.)

Alphanumeric - Up to 80 characters

CLAIMTYPE

The claim's type (professional or institutional)

P: Professional
I: Institutional

CTRLNO1

The primary insurance Orig Claim # set on the claim.

Alphanumeric - Up to 50 characters

CTRLNO2

The secondary insurance Orig Claim # set on the claim.

Alphanumeric - Up to 50 characters

CTRLNO3

The tertiary insurance Orig Claim # set on the claim.

Alphanumeric - Up to 50 characters

ENTERED

The date/time that the claim was entered into CollaborateMD.

Date/Time

FACILITY

The ID of the facility set on the claim.  Foreign key to the SEQNO column in Facility.

Numeric - 8 digits

FOLLOWUP

The Follow Up Date set on the claim.

Date

FROMDATE

The "From" date of service of the claim.

Date

INSGRPID1

The primary insurance Group Number set on the claim.

Alphanumeric - Up to 29 characters

INSGRPID2

The secondary insurance Group Number set on the claim.

Alphanumeric - Up to 29 characters

INSGRPID3

The tertiary insurance Group Number set on the claim.

Alphanumeric - Up to 29 characters

INITTREATMENT

The Initial Treatment Date set on the claim.

Date

INSID1

The primary insurance Member ID set on the claim.

Alphanumeric - Up to 20 characters

INSID2

The secondary insurance Member ID set on the claim.

Alphanumeric - Up to 20 characters

INSID3

The tertiary insurance Member ID set on the claim.

Alphanumeric - Up to 20 characters

LASTSEENDT

The Date Last Seen set on the claim.

Date

LMP

The Last Menstrual Period set on the claim.

Date

MCAID90CODE

The Delay Reason Code set on the claim.

1: Proof of Eligibility Unknown or Unavailable
2: Litigation
3: Authorization Delays
4: Delay in Certifying Provider
5: Delay in Supplying Billing Forms
6: Delay in Delivery of Custom-made Appliances
7: Third Party Processing Delay
8: Delay in Eligibility Determination
9: Original Claim Rejected or Denied Due to a Reason Unrelated to the Billing Limitation Rules
10: Administration Delay in the Prior Approval Process
12: Other
15: Natural Disaster

NONWORKFRDT

The Unable to Work From Date set on the claim.

Date

NONWORKTODT

The Unable to Work To Date set on the claim.

Date

ONSETDATE

The Accident/Illness Date set on the claim.

Date

ORDERING

The ID of the ordering provider set on the claim.
(This represents the other provider on institutional claims.)  Foreign key to the SEQNO column in Referring.

Numeric - 8 digits

PATIENT

The ID (account number) of the patient set on the claim.  Foreign key to the PACCTNO column in Patient.

Numeric - 8 or 9 digits

PAYOR1

The ID of the primary payer set on the claim.  Foreign key to the SEQNO column in Payer.

Numeric - 8 digits

PAYOR2

The ID of the secondary payer set on the claim.  Foreign key to the SEQNO column in Payer.

Numeric - 8 digits

PAYOR3

The ID of the tertiary payer set on the claim.  Foreign key to the SEQNO column in Payer.  

Numeric - 8 digits

PRACTICE

The  ID of the practice set on the claim (this will be the Rendering provider's Practice).  Foreign key to the SEQNO column in Practice.
Numeric - 8 digits

REFERRING

The ID of the referring provider set on the claim.  Foreign key to the SEQNO column in Referring.

Numeric - 8 digits

RENDERING

The ID of the rendering provider set on the claim.
(This represents the attending provider on institutional claims.)  Foreign key to the SEQNO column in Provider.

Numeric - 8 digits

SALESREP


The ID of the sales rep set on the claim.
 Foreign key to the SEQNO column in Provider.  Foreign key to the SEQNO column in Referring.
Numeric - 8 digits

SUPERVISING

The ID of the supervising provider set on the claim.
(This represents the operating provider on institutional claims.)  Foreign key to the SEQNO column in Provider.

Numeric - 8 digits

TODATE

The "To" date of service of the claim.

Date