Parent File | Name | Number | Package |
---|---|---|---|
ELECTRONIC REMITTANCE ADVICE(#344.4) | ERA DETAIL | 344.41 | Accounts Receivable |
Field # | Name | Loc | Type | Details |
---|---|---|---|---|
.01 | SEQUENCE # | 0;1 | NUMBER | ************************REQUIRED FIELD************************
|
.02 | EOB DETAIL | 0;2 | POINTER TO EXPLANATION OF BENEFITS FILE (#361.1) | EXPLANATION OF BENEFITS(#361.1)
|
.03 | AMOUNT PAID | 0;3 | NUMBER |
|
.04 | INSURANCE COMPANY ON BILL | 0;4 | POINTER TO INSURANCE COMPANY FILE (#36) | INSURANCE COMPANY(#36)
|
.05 | INVALID BILL NUMBER | 0;5 | FREE TEXT |
|
.07 | ERROR CATEGORY | 0;7 | SET |
|
.08 | UNSPECIFIC ERROR | 0;8 | FREE TEXT |
|
.09 | TRANSFERRED OUT MSG # | 0;9 | FREE TEXT |
|
.1 | TRANSFER STATUS | 0;10 | SET |
|
.11 | TRANSFERRED TO SITE | 0;11 | POINTER TO INSTITUTION FILE (#4) | INSTITUTION(#4)
|
.12 | TRANSFERRED DATE | 0;12 | DATE |
|
.13 | ERROR STATUS | 0;13 | SET |
|
.14 | REVERSAL | 0;14 | SET |
|
.15 | FREE TEXT PATIENT NAME | 0;15 | FREE TEXT |
|
.16 | TRANSFER RECEIVED OTHER SITE | 0;16 | SET |
|
.17 | BILL NUMBER FROM PAYER | 0;17 | FREE TEXT |
|
.18 | BILLING PROVIDER NPI | 3;1 | FREE TEXT |
|
.19 | RENDERING/SERVICING PROV NPI | 3;2 | FREE TEXT |
|
.2 | ENTITY TYPE QUALIFIER | 3;3 | SET |
|
.21 | RENDERING/SERVICING PROV NAME | 3;4 | FREE TEXT |
|
.22 | BILLING PROV COMMENT | 3;5 | FREE TEXT |
|
.23 | REN PROV COMMENT | 4;1 | FREE TEXT |
|
.24 | ECME # | 4;2 | FREE TEXT |
|
.25 | RECEIPT | 4;3 | POINTER TO AR BATCH PAYMENT FILE (#344) | AR BATCH PAYMENT(#344)
|
1 | RAW DATA | 1;0 | WORD-PROCESSING #344.411 |
|
1.1 | FORMATTED MESSAGE DATA | COMPUTED |
|
|
2 | RESOLUTION LOG | 2;0 | WORD-PROCESSING #344.412 |
|
4 | CLAIM COMMENT | 6;3 | FREE TEXT |
|
4.01 | CLAIM COMMENT DATE | 6;2 | DATE |
|
4.02 | CLAIM COMMENT USER | 6;1 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
5 | AUTO-POST REJECTION REASON | 5;1 | SET |
|
6 | MARK FOR AUTO-POST | 5;2 | SET |
|
6.01 | MARKED FOR AUTOPOST USER | 5;7 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
7 | AUTO-DECREASE INDICATOR | 5;3 | SET |
|
8 | AUTO-DECREASE AMOUNT | 5;4 | NUMBER |
|
9 | AUTO-POST DATE | 5;5 | DATE |
|
9.01 | PHARMACY CLAIM COMMENT | 9;1 | FREE TEXT |
|
9.02 | MCCF DATE/TIME | 9;2 | DATE |
|
10 | AUTO-DECREASE DATE | 5;6 | DATE |
|
10.01 | CHECKED FOR FIRST PARTY AD | 5;8 | SET |
|
99 | BILL REFERENCE NUMBER | COMPUTED |
|