FileMan FileNo | FileMan Filename | Package |
---|---|---|
9000006.01 | PRIVATE INSURANCE CLAIMS | IHS Patient |
Package | Total | FileMan Files |
---|---|---|
IHS Patient | 2 | PRIVATE INSURANCE ELIGIBLE(#9000006)[.02] VISIT(#9000010)[.03] |
Utility Tables | 1 | LOCATION(#9999999.06)[.05] |
Field # | Name | Loc | Type | Details |
---|---|---|---|---|
.01 | CLAIM | 0;1 | DATE | ************************REQUIRED FIELD************************
|
.02 | PATIENT NAME | 0;2 | POINTER TO PRIVATE INSURANCE ELIGIBLE FILE (#9000006) | ************************REQUIRED FIELD************************ PRIVATE INSURANCE ELIGIBLE(#9000006)
|
.03 | VISIT | 0;3 | POINTER TO VISIT FILE (#9000010) | ************************REQUIRED FIELD************************ VISIT(#9000010)
|
.04 | CLAIM AMOUNT | 0;4 | NUMBER | ************************REQUIRED FIELD************************
|
.05 | FACILITY | 0;5 | POINTER TO LOCATION FILE (#9999999.06) | ************************REQUIRED FIELD************************ LOCATION(#9999999.06)
|
.06 | SETTLEMENT DATE | 0;6 | DATE |
|
.07 | SETTLEMENT AMOUNT | 0;7 | NUMBER |
|
.08 | DENIAL CODE | 0;8 | FREE TEXT |
|
.09 | BEGIN CLAIM DATE | 0;9 | DATE | ************************REQUIRED FIELD************************
|
.11 | END CLAIM DATE | 0;11 | DATE | ************************REQUIRED FIELD************************
|
.12 | TYPE OF CLAIM | 0;12 | SET | ************************REQUIRED FIELD************************
|
.13 | DRG CODE | 0;13 | NUMBER |
|
.14 | DRG AMOUNT | 0;14 | NUMBER |
|
.15 | TRANSMITTAL NUMBER | 0;15 | NUMBER |
|
.16 | REBILL FLAG | 0;16 | SET |
|