claims


If there is patient data for this table the file for this export will be found in the extracted zip folder location under the filename of claims.csv

If there are non-patient data column elements that are not part of the designated record set they will be marked in the Comment's column for that data element

Description

Insurance Billing Claims - Used for tracking and submission of billing claims to payers

Columns

Column Type Size Nulls Auto Default Children Parents Comments
patient_id BIGINT 19 null
patient_data.pid Defined in XML R

The internal patient identifier

encounter_id INT 10 null
form_encounter.encounter Defined in XML R

Encounter identifier - Identifier for the patient encounter associated with the claim

version INT UNSIGNED 10 null

Claim version - Incremented in code to track changes in claims

payer_id INT 10 0
insurance_companies.id Defined in XML R

The insurance company being billed. If this is self-pay the id will be 0

status TINYINT 3 0

Claim status - Status of the billing claim. -1=Leave Unchanged,1=Unbilled,2=Mark as billed, 7=Denied

payer_type TINYINT 3 0

The payer type code, indicating the source of payment (0=patient, 1=primary insurance, 2=secondary insurance, etc).

bill_process TINYINT 3 0

Billing process status. -1=Leave unchanged, 0=Claim is open,1=Processing in progress,2=Billed,3=Error

bill_time DATETIME 19 NULL

Billing time - The datetime this bill was created

process_time DATETIME 19 NULL

Processing time - Time of claim processing

process_file VARCHAR 255 NULL

Processing file - File associated with claim processing

target VARCHAR 30 NULL

Claim target - Target associated with the claim

x12_partner_id INT 10 0

X12 Partner identifier - Identifier for the X12 partner. Empty in export

submitted_claim MEDIUMTEXT 16777215 NULL

Submitted claim - Claims form data

Indexes

Constraint Name Type Sort Column(s)
PRIMARY Primary key Asc/Asc/Asc patient_id + encounter_id + version

Relationships