Overview
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Sample Reports
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Portal
Back Office
Field Definitions
Field | Description |
|---|---|
| Practice | The practice for which the charge is being billed. |
| Account ID | The account number of the guarantor account. Displays as Account Prefix + Account ID. |
| Case ID | The unique number assigned to the case. |
| Facility Case Number | The case number issued by the facility, i.e., Medical Record Number. |
| Payment Batch ID | The unique identification number of the payment batch including the payment. |
| Payment ID | The unique identification number assigned to the payment when it was created. |
| ERA | Indicates whether the payment was applied via an ERA. Values include: Yes or No. |
| Check Date | The date on the remitted check. |
| Check Number | The check number of the remitted check. |
| Check Amount | The amount of the remitted check. |
| Remitter | The name of the payer, person, or organization that issued the payment. |
| Patient | The name of the patient on the case. The person treated on the case. |
| Patient DOB | The patient's Date of Birth. |
| Rendering Provider | The name of the provider (last name, first name middle) who performed the procedure on the case. |
| Rendering Provider NPI | The NPI (National Provider Identifier) for the Rendering Provider. |
| Referring Provider | The name of the physician(last name, first name middle) who referred the patient. |
| Payer | The primary insurance payer on the case with financial responsibility for the outstanding debt. |
| Plan | The primary insurance plan on the case to which charges were billed. |
| Member Number | The unique number issued by the payer to identify the patient who participates in a group plan. |
| Group Number | The unique number issued by the payer to the owner of the insurance policy. |
| Payment Rank | The rank of the payer when there is one or more payers on the case. By default, this option is set to the primary payer. If the case has multiple payers, you can specify the rank of the payer to which a payment is being applied. |
| Payment Type | The type of payment, as entered during creation of the payment. Values include:
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| Transaction Type | The type of transaction used for the payment, e.g, credit card, check. |
| Claim | The Claim ID to which the insurance payment has been applied. |
| Control Number | The control number assigned tot he insurance payment. |
| Date of Service | The date the service is rendered. |
| Procedure Minutes | The total number of minutes needed to perform the procedure. |
| Base Units | The total number of base units billed for the case. |
| Time Units | The total number of time units billed for the case. |
| Physical Status Units | The total number of physical status units billed for the case. |
| Total Units | The sum of base, time, and physical units billed. |
| Work RVU | The work relative value unit entered on the General procedure in the billing fee schedule to which the payer or plan is associated and to which the claim was billed. |
| Anesthesia Method | Method used to administer anesthesia, e.g., General, Regional. |
| Physical Status Level | The physical status of the patient, as indicated in charge entry. |
| Place of Service | The individual place of service type where services are rendered. |
| Type of Service | The type of procedure: Anesthesia or General. |
| Case Reporting Type | The Case Reporting Type for the associated case. |
| CPT | The general procedure code that was entered as the procedure billed on the case in charge entry. |
| ASA | The anesthesia procedure code that was entered as the procedure billed on the case in charge entry. |
| Modifier 1 | The primary modifier entered on the procedure of the case. |
| Modifier 2 | The second modifier entered on the procedure of the case. |
| Modifier 3 | The third modifier entered on the procedure of the case. |
| Modifier 4 | The fourth modifier entered on the procedure of the case. |
| Diagnosis 1 | The primary diagnosis entered on the case. |
| Diagnosis 2 | The secondary diagnosis entered on the case. |
| Diagnosis 3 | The tertiary diagnosis entered on the case. |
| Diagnosis 4 | The fourth diagnosis entered on the case. |
| Billed | The amount billed for the procedure. |
| Expected | The amount of reimbursement expected from the payer or plan for the services rendered. This amount is calculated by the applicable expected fee schedule. |
| Allowed | The amount the payer will reimburse for the procedure. |
| Payment | The amount of the payment. |
| Deductible | The specified amount of money that the insured must pay before an insurance company will pay a claim. |
| Copay | A payment made by a beneficiary in addition to that made by an insurer. |
| Coinsurance | The calculated amount outstanding after deductible, copay, payment, contractual write-off, and adjustment amounts are applied. The coinsurance amount is calculated as follows:
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| Contractual Writeoffs | The calculated amount to be written off due to the contractual agreement between the practice and the primary payer. Contractual write-offs pertain only to the primary payer on the claim. The contractual write-off amount is the difference of the billed amount and the allow amount (Billed – Allow = Cont WO). |
| Withhold | The amount being withheld by the payer on the claim, as indicated on the EOB. Withholding is primarily associated with managed care, such as HMO plans. |
| Denial Code | The unique identification for the denial reason for the claim. |
| Remark Code | Remittance Advice Remark Codes are used to provide additional explanation for an adjustment already described by a CARC or to convey information about remittance processing. |
| Adjustments Negative | The sum of negative adjustments made against the payment. |
| Adjustments Positive | The sum of positive adjustments made against the payment. |
| Balance | The amount of the current balance on the procedure. |
| Accounting Date | The accounting date for this payment. |
| Posted Date | The date the transaction was posted to the guarantor account. |
Available Report Filters
Option | Type | Required | Description |
|---|---|---|---|
| Date Mode | Drop Down | Yes | Determines how the results are grouped and ordered:
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| Practices | List Selection | Yes | Filters by all practices or by one or more practices. By default, this filter is set to All. |
| Providers | List Selection | Yes | Filters by all providers or by one or more providers. By default, this filter is set to All. |
| Referring Providers | List Selection | Filters by all referring providers or by one or more referring providers. By default, this filter is set to All. | |
| Facilities | List Selection | Yes | Filters by all facilities or by one or more facilities. By default, this filter is set to All. |
| Payers | List Selection | Yes | Filters by payer to which the claims were submitted. By default, this filter is set to All. |
| Plans | List Selection | Yes | Filters by plan to which claims were submitted. By default, this filter is set to All. |
| Report Folder | Drop Down | Yes | Designates where to place or save the output from the executed report. |