Files > ERA DETAIL

parent
344.4
name
ERA DETAIL
number
344.41
Fields
#NameLocationTypeDetailsIndexDescription
.01sequence #(+)0;1NUMERICBThis is a sequence # used internally to identify this ERA detail record.
.02eob detail0;2POINTER361.1ACThe detail EOB records that comprise the 835 transaction.
.03amount paid0;3NUMERICThis is the specific amount the payer has paid on this bill.
.04insurance company on bill0;4POINTER36This is the insurance company that supplied this EOB data
.05invalid bill number0;5FREE TEXTADThis is the bill # received on the EOB, but it doesn't exist in VistA.
.07error category0;7SET OF CODES1:VALID BILL NOT FOUND
2:EOB DETAIL NOT IN IB
99:OTHER
AEXCThis field is used to categorize the specific errors associated with EOB detail records. This is the coded error for special exception processing.
.08unspecific error0;8FREE TEXTThis is the text to describe the error associated with EOB detail records when the ERROR CATEGORY field is OTHER.
.09transferred out msg #0;9FREE TEXTThis field will hold the last mail message number used to transmit a detail record for an EOB received for a bill belonging to another site.
.1transfer status0;10SET OF CODES0:NOT ACCEPTED
1:ACCEPTED
This field indicates whether or not an EOB transfer has been accepted by a site to whom this EOB detail record was sent.
.11transferred to site0;11POINTER4This is the name of the site where the EOB detail record will be sent.
.12transferred date0;12DATE-TIMEATOUTThis is the latest date/time when the transfer of the EOB detail record took place.
.13error status0;13SET OF CODES0:UNRESOLVED
1:RESOLVED
This indicates if the error associated with this EOB detail record was resolved or not. If resolved, it will not appear on any more EOB detail exception lists.
.14reversal0;14BOOLEAN0:NO
1:YES
ATBThis is the flag that indicates the bill was not paid, but was reversed.
.15free text patient name0;15FREE TEXTThis is the name of the patient as returned by the payer. Used only if the bill cannot be found at the site.
.16transfer received other site0;16BOOLEAN0:NO
1:YES
This indicates whether or not the other site has received the transferred EOB record.
.17bill number from payer0;17FREE TEXTIf a bill number must be edited because it could not be found in the site's A/R file, this is the original bill # that the payer sent.
.18billing provider npi3;1FREE TEXTThis field contains the NPI for the Billing Provider that is found in piece 16 of the line type 10 of the 835ERA sent from Austin Information Technology Center.
.19rendering/servicing prov npi3;2FREE TEXTThis field contains the NPI for the Rendering/Servicing Provider that is found in piece 16 of the line type 10 of the 835ERA sent from the Austin Information Technology Center. This field is named Rendering NPI on the 835ERA and can contain the NPI for the Rendering (individual) or the Servicing (non-individual) provider.
.2entity type qualifier3;3SET OF CODES1:INDIVIDUAL
2:NON-INDIVIDUAL
This field reflects the type of NPI that is being returned in the NM1 segment of the X12N 835. If it is a 1 then the NPI is for an individual provider. If it is a 2 then it is a non-individual (organizational) NPI. This data is found in piece 17 of line type 10 in the 835ERA message transmitted from the Austin Information Technology Center.
.21rendering/servicing prov name3;4FREE TEXTThis field holds the value of the "Rendering Provider Name" field from the NM1 segment of the X12N 835. It is last name (or servicing organization name) concatenated with a comma (if there is a first name) concatenated with the first name. The last name is piece 18 of a line type of 10 in the 835ERA message and the first name is piece 19 of a line type of 10 in the 835ERA message transmitted from the Austin Information Technology Center.
.22billing prov comment3;5FREE TEXTThis comment is about the Billing Provider NPI. This field is filled in only if the NPI is not in proper format.
.23ren prov comment4;1FREE TEXTThis field is filled in with a comment if the Rendering/Servicing Provider NPI is not in correct format.
.24ecme #4;2FREE TEXTECMEThe ELECTRONIC CLAIMS MANAGEMENT ENGINE NUMBER is used to track an ERA for matching, posting, and reporting claims.
.25receipt4;3POINTER344RECEIPTThis is the AR BATCH PAYMENT entry that has the associated Receipt Number.
1raw data1;0WORD-PROCESSINGThis field stores the raw data as it was received for the individual EOB if its detail could not be stored in IB.
1.1formatted message dataCOMPUTED
2resolution log2;0WORD-PROCESSINGThis field contains comments to detail the attempts made to remove the exception condition associated with this individual EOB.
5auto-post rejection reason5;1SET OF CODES1:FIELD VERIFICATION FAILED
2:CLAIM ALREADY COMPLETED/CLOSED
3:PAYMENT EXCEEDS CLAIM BALANCE
4:REFERRED TO GENERAL COUNCIL
5:REJECTED (COMPLETED/CLOSED)
6:PAYMENT AMOUNT IS NEGATIVE
7:REJECTED (GENERAL COUNCIL)
This field describes the reason that caused the ERA detail line to be rejected by the ERA auto-posting process in the AR nightly job.
6mark for auto-post5;2BOOLEAN0:NO
1:YES
APThis flag identifies if the EEOB line item in the ERA is marked for automatic posting to a receipt during the nightly job process.
7auto-decrease indicator5;3BOOLEAN1:YES
This field indicates that the claim on this ERA DETAIL line has been reviewed by the nightly decrease adjustment process.
8auto-decrease amount5;4NUMERICThis is the dollar amount of the decrease adjustment applied to the claim on this ERA DETAIL line by the nightly automatic decrease adjustment process.
9auto-post date5;5DATE-TIMEFThis is the date on which the claim line was auto-posted by the AR Nightly process.
9.01pharmacy claim comment9;1FREE TEXTThis field is informational and is to aid users in the processing of pharmacy claims.
10auto-decrease date5;6DATE-TIMEGThis is the date on which the claim line was auto-decreased by the AR Nightly process.
99bill reference numberCOMPUTED

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