|
TYPE |
LEN |
REQ |
VALUE |
NOTES |
|
PK |
Y |
Charge Primary Key |
||
|
VARCHAR |
100 |
Y |
Client ID |
Healthjump’s client identifier. |
|
VARCHAR |
36 |
Client Charge ID |
Charge ID obtained from the source system. |
|
|
VARCHAR |
40 |
Encounter ID |
|
|
|
VARCHAR |
40 |
Patient ID |
||
|
VARCHAR |
36 |
Primary Payer ID |
|
|
|
VARCHAR |
500 |
Primary Financial Class |
Name of financial class. |
|
|
VARCHAR |
50 |
Primary Insurance Payer |
Name of primary insurance payer. |
|
|
VARCHAR |
36 |
Secondary Payer ID |
|
|
|
VARCHAR |
500 |
Secondary Financial Class |
Name of financial class. |
|
|
VARCHAR |
50 |
Secondary Insurance Payer |
Name of secondary insurance payer. |
|
|
VARCHAR |
36 |
Tertiary Payer ID |
|
|
|
VARCHAR |
500 |
Tertiary Financial Class |
Name of tertiary financial class. |
|
|
VARCHAR |
50 |
Tertiary Insurance Payer |
Name of the tertiary insurance payer. |
|
|
VARCHAR |
500 |
CPT Code |
||
|
VARCHAR |
100 |
CPT Modifiers |
||
|
VARCHAR |
2 |
Place of Service |
||
|
VARCHAR |
50 |
Location of Service |
||
|
VARCHAR |
8 |
Beginning Date of Service |
Format: YYYYMMDD |
|
|
VARCHAR |
8 |
Ending Date of Service |
Format: YYYYMMDD |
|
|
VARCHAR |
8 |
Posting Date of Charge |
Format: YYYYMMDD |
|
|
VARCHAR |
8 |
Entered Date of Charge |
Format: YYYYMMDD |
|
|
NUMERIC |
19, 2 |
Units |
||
|
NUMERIC |
19, 2 |
Charge Amount |
||
|
NUMERIC |
19, 2 |
Allowed Amount |
||
|
NUMERIC |
19, 2 |
Primary Payer Amount Paid |
||
|
NUMERIC |
19, 2 |
Secondary Payer Amount Paid |
||
|
NUMERIC |
19, 2 |
Tertiary Payer Amount Paid |
||
|
NUMERIC |
19, 2 |
Patient Amount Paid |
||
|
NUMERIC |
19, 2 |
Primary Payer Adjusted Amount |
||
|
NUMERIC |
19, 2 |
Secondary Payer Adjusted Amount |
||
|
NUMERIC |
19, 2 |
Tertiary Payer Adjusted Amount |
||
|
NUMERIC |
19, 2 |
Patient Adjusted Amount |
||
|
VARCHAR |
36 |
Rendering Provider ID |
Rendering provider ID obtained from the source system. |
|
|
VARCHAR |
10 |
Rendering Provider NPI |
||
|
VARCHAR |
77 |
Rendering Provider Name |
Rendering providers full name. |
|
|
DATE (Time) |
|
HJ Create Timestamp |
For internal Healthjump use and reference. |
|
|
DATE (Time) |
HJ Modify Timestamp |
For internal Healthjump use and reference. | ||
|
VARCHAR |
10 |
dx1 Code |
|
|
|
VARCHAR |
10 |
dx2 Code |
|
|
|
VARCHAR |
10 |
dx3 Code |
|
|
|
VARCHAR |
10 |
dx4 Code |
|
|
|
VARCHAR |
10 |
dx5 Code |
|
|
|
VARCHAR |
10 |
dx6 Code |
|
|
|
VARCHAR |
10 |
dx7 Code |
|
|
|
VARCHAR |
10 |
dx8 Code |
|
|
|
CHAR |
32 |
Row Hash |
For internal Healthjump use and reference. |