Skip to end of metadata
Go to start of metadata

You are viewing an old version of this content. View the current version.

Compare with Current View Version History

Version 1 Next »

Payments Reference Report shows summary of payment references received from payers. 

Payment References Worksheet

The worksheet contains the summary of all payment references submitted by payers in Remittance.Advice transactions.

Data in the worksheet is sorted by:

  1. Settlement Date, descending;
  2. Payer ID, ascending;
  3. Payment Reference, ascending.

The table below describes columns presented on this worksheet.

Column
Description
Payer IDLicense number of an insurance company that is the payer of a number of claims grouped by the same payment reference number.
Payer NameName 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 ReferencePayment reference number.
Payment Amount

The sum of all Activity.PaymentAmount across all received Remittance.Advice transactions for the same Settlement Date and Payment Reference.

Claim Payments Worksheet

Thie worksheet contains payment references for every claim submitted by payers in Remittance.Advice transactions.

Data in the worksheet is sorted by:

  1. Settlement Date, descending;
  2. Payer ID, ascending;
  3. Payment Reference, ascending;
  4. Claim.ID, ascending.

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 NameName of an insurance company that is the payer of a claim.
Claim IDID assigned to a claim by a provider.
Claim ID PayerID assigned to a claim by a 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 a patient.

MRN

Patient Medical Record Number assigned by the provider.

Settlement Date

Settlement date of the payment.

Payment ReferencePayment reference number.
Payment Amount

Payment amount for the clai. 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:

  1. Settlement Date, descending;
  2. Payer ID, ascending;
  3. Payment Reference, ascending;
  4. Claim.ID, ascending;
  5. Activity ID, ascending.

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 NameName of an insurance company that is the payer of a claim.
Claim IDID assigned to a claim by the provider.
Claim ID PayerID assigned to a claim by the payer.
Member ID

Insurance card number of patient.

MRN

Patient Medical Record Number assigned by the provider.

Activity IDID of an activity.
Auth. Number

Prior authorization number.

Rx NumberRx 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 CounterFill 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 ReferencePayment reference number.
Payment Amount

Payment amount for an activity.

  • No labels