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
|