Payments Reference Report shows summary of payment references received from payers. This is an Excel file containing three worksheets - levels of data aggregation:
- Payment References
- Claim Payments
- Activity Payments
Payment References
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worksheet
The worksheet contains
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summary of all payment references submitted by payers in Remittance.Advice transactions.
Data in the worksheet is sorted by:
- Settlement Date, descending;
- Payer ID, ascending;
- Payment Reference, ascending.
The table below describes the columns presented on this worksheet.
Column | Description |
|---|---|
| Payer ID | License number of an insurance company that is the payer of a number of claims grouped by the same payment reference number. |
| Payer Name | Name of an insurance company that is the payer of a number of claims grouped by the same payment reference number. |
| Settlement Date | Settlement date of the payment. |
| Payment Reference | Payment reference number. |
| Payment Amount |
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Payment amount for claims batch. Calculates as the sum of |
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Activity.PaymentAmount |
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for the |
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Claim Payments Worksheet
Thie worksheet contains payment references for every claim submitted by payers in Remittance.Advice transactions.
respective activities. |
Data in the worksheet is sorted by:
- Settlement Date, descending;
- Payer ID, ascending;
- Payment Reference, ascending
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- .
Claim
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Payments worksheet
The worksheet contains payment references for every claim submitted by payers in Remittance.Advice transactions.
The table below describes the columns presented on this worksheet.
Column | Description |
|---|---|
| Payer ID | License number of an insurance company that is the payer of a claim. |
| Payer Name | Name of an insurance company that is the payer of a claim. |
| Claim ID |
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| Unique identifier assigned to a claim by |
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| the provider. |
| Claim ID Payer |
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| Unique identifier assigned to a claim by |
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| the payer. | |
| Encounter Start | Encounter start date and time. If a claim has more than one encounter, then this value is taken from the earliest encounter. |
| Member ID | Insurance card number of |
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the patient. | |
| MRN | Patient Medical Record Number assigned by the provider. |
| Settlement Date | Settlement date of the payment. |
| Payment Reference | Payment reference number. |
| Payment Amount | Payment amount for the |
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claim. Calculates as the sum of Activity.PaymentAmount for the respective activities. |
Activity Payments Worksheet
The worksheet contains payment references for every activity submitted by payers in Remittance.Advice transactions.
Data in the worksheet is sorted by:
- Settlement Date, descending;
- Payer ID, ascending;
- Payment Reference, ascending;
- Claim.ID, ascending
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- .
Activity Payments worksheet
The worksheet contains payment references for every activity submitted by payers in Remittance.Advice transactions.
The table below describes columns presented on this worksheet.
Column | Description |
|---|---|
| Payer ID | License number of an insurance company that is the payer of a claim. |
| Payer Name | Name of an insurance company that is the payer of a claim. |
| Claim ID |
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| Unique identifier assigned to a claim by the provider. |
| Claim ID Payer |
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| Unique identifier assigned to a claim by the payer. | |
| Member ID | Insurance card number of the patient. |
| MRN | Patient Medical Record Number assigned by the provider. |
| Activity ID |
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| Unique identifier of an activity. | |
| Auth. Number | Prior authorization number. |
| Rx Number | Rx Number. It is taken from an observation with Observation.Code = Prescription No. Column is shown if there is at least one activity with the said observation. |
| Fill Counter | Fill Counter. It is taken from an observation with Observation.Code = Refills or Fill Counter. Column is shown if there is at least one activity with the said observation. |
| Service Date | Date of the provided service. |
| Settlement Date | Settlement date of the payment. |
| Payment Reference | Payment reference number. |
| Payment Amount | Payment amount for an activity. |
Data in the worksheet is sorted by:
- Settlement Date, descending;
- Payer ID, ascending;
- Payment Reference, ascending;
- Claim.ID, ascending;
- Activity ID, ascending.