Parent File | Name | Number | Package |
---|---|---|---|
9002080.01 | TRANSACTION RECORD | 9002080.02 | Contract Health Management Information System |
Field # | Name | Loc | Type | Details |
---|---|---|---|---|
.01 | TRANSACTION DATE | 0;1 | DATE |
|
1 | TRANSACTION TYPE | 0;2 | SET |
|
2 | PATIENT | 0;3 | POINTER TO PATIENT FILE (#9000001) | PATIENT(#9000001)
|
3 | IHS PAYMENT AMOUNT | 0;4 | NUMBER |
|
4 | FULL PAYMENT | 0;5 | SET |
|
5 | SUPPLEMENT NUMBER | 0;6 | NUMBER |
|
6 | CANCEL NUMBER | 0;7 | NUMBER |
|
7 | THIRD PARTY PAY AMT | 0;8 | NUMBER |
|
8 | WORKLOAD | 0;9 | NUMBER |
|
9 | DATE OF SERVICE | 0;10 | DATE |
|
9.1 | HOSPITAL OUTPATIENT | 0;16 | SET |
|
11 | CHS CLERK | 0;11 | POINTER TO NEW PERSON FILE (#200) | ************************REQUIRED FIELD************************ NEW PERSON(#200)
|
12 | THIRD PARTY SOURCE | 0;12 | POINTER TO INSURER FILE (#9999999.18) | INSURER(#9999999.18)
|
13 | EOBR DATE | 0;13 | DATE |
|
14 | EOBR CLAIM SEQ NO. | 0;14 | NUMBER |
|
15 | EOBR PAY TYPE | 0;15 | SET |
|
16 | EOBR CONTROL NUMBER | 0;17 | FREE TEXT |
|
17 | EOBR CHECK NUMBER | 0;18 | NUMBER |
|
18 | EOBR REMITTANCE NUMBER | 0;19 | NUMBER |
|
19 | EOBR SERVICES BILLED | 0;20 | SET |
|
20 | EOBR OBLIGATION TYPE | 0;21 | SET |
|
22 | INTEREST CAN | 0;22 | POINTER TO CHS COMMON ACCOUNTING NUMBER FILE (#9002062) | CHS COMMON ACCOUNTING NUMBER(#9002062)
|
23 | INTEREST OBJECT CLASS CODE | 0;23 | FREE TEXT |
|
24 | INTEREST RATE | 0;24 | NUMBER |
|
25 | INTEREST DAYS ELIGIBLE | 0;25 | NUMBER |
|
26 | INTEREST PAID | 0;26 | NUMBER |
|
27 | INTEREST ADDTNL PENALTY PAID | 0;27 | NUMBER |
|
28 | INTEREST TOTAL PAID THIS TRANS | 0;28 | NUMBER |
|
29 | CANCEL/ADJUSTMENT REASON | 0;29 | NUMBER |
|
30 | PAYMENT SCHEDULE NUMBER | 0;30 | NUMBER |
|
31 | 278O ID | 0;31 | NUMBER |
|