Parent File | Name | Number | Package |
---|---|---|---|
EXPLANATION OF BENEFITS(#361.1) | MOVE/COPY/REMOVE HISTORY | 361.1101 | Integrated Billing |
Field # | Name | Loc | Type | Details |
---|---|---|---|---|
.01 | DATE/TIME EEOB MOVED | 0;1 | DATE | ************************REQUIRED FIELD************************
|
.02 | EEOB MOVE/COPY/REMOVE BY | 0;2 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
.03 | MOVE/COPY/REMOVE REASON | 0;3 | FREE TEXT |
|
.04 | ORIGINAL BILL NUMBER | 0;4 | POINTER TO BILL/CLAIMS FILE (#399) | BILL/CLAIMS(#399)
|
.05 | MOVE/COPY/REMOVE EVENT | 0;5 | SET |
|
.06 | OTHER CLAIM NUMBERS | 1;0 | POINTER Multiple #361.11016 | 361.11016
|