| FileMan FileNo | FileMan Filename | Package |
|---|---|---|
| 364 | EDI TRANSMIT BILL | Integrated Billing |
| Package | Total | FileMan Files |
|---|---|---|
| Integrated Billing | 3 | EDI MESSAGES(#364.2)[.05] BILL STATUS MESSAGE(#361)[.11] EXPLANATION OF BENEFITS(#361.1)[.19] |
| Package | Total | FileMan Files |
|---|---|---|
| Integrated Billing | 2 | BILL/CLAIMS(#399)[.01] EDI TRANSMISSION BATCH(#364.1)[.02, .06] |
| Field # | Name | Loc | Type | Details |
|---|---|---|---|---|
| .01 | BILL NUMBER | 0;1 | POINTER TO BILL/CLAIMS FILE (#399) | ************************REQUIRED FIELD************************ BILL/CLAIMS(#399)
|
| .02 | BATCH NUMBER | 0;2 | POINTER TO EDI TRANSMISSION BATCH FILE (#364.1) | EDI TRANSMISSION BATCH(#364.1)
|
| .03 | TRANSMISSION STATUS | 0;3 | SET | ************************REQUIRED FIELD************************
|
| .04 | STATUS DATE | 0;4 | DATE |
|
| .06 | RESUBMIT BATCH NUMBER | 0;6 | POINTER TO EDI TRANSMISSION BATCH FILE (#364.1) | EDI TRANSMISSION BATCH(#364.1)
|
| .07 | TEST BILL | 0;7 | SET |
|
| .08 | COB SEQUENCE | 0;8 | SET |
|
| .09 | 837 FHIR TRANS REQUEST | 0;9 | SET |
|
| .1 | RESUBMISSION | 0;10 | SET |
|
| .11 | FHIR BUNDLE VALIDATION | 0;11 | SET |
|
| .12 | OLD STATUS | 0;12 | FREE TEXT |
|
| ICR LINK | Subscribing Package(s) | Fields Referenced | Description |
|---|---|---|---|
| ICR #6208 | BILL NUMBER (.01). Access: Read w/Fileman BATCH NUMBER (.02). Access: Read w/Fileman |