| # | Name | Location | Type | Details | Index | Description |
|---|---|---|---|---|---|---|
| .01 | message #(+) | 0;1 | FREE TEXT | B | ||
| .02 | message type | 0;2 | POINTER | 364.3 | AMT | This field contains the type of message that is represented by this record. It is used to determine the type of processing and processing options that will be allowed for this message. |
| .03 | date recorded | 0;3 | DATE-TIME | ARD | This is the date and time that this record was recorded in this file. | |
| .04 | batch number | 0;4 | POINTER | 364.1 | ABA | This is the batch number this message is associated with. This field only applies to message types that deal with batch processing. |
| .05 | transmit bill | 0;5 | POINTER | 364 | ABI | This is the bill number this message is associated with. This field only applies to message types that deal with bill processing. |
| .06 | status(+) | 0;6 | SET OF CODES | P:PENDING U:UPDATING | AMS | This is the current status of this message. |
| .07 | patient | 0;7 | POINTER | 2 | If this is not a bill processing type message, it must be a patient type message. This is the name of the patient referenced in this type of record. | |
| .08 | source level | 0;8 | SET OF CODES | 0:PRIOR TO PAYER 1:FROM PAYER | This field identifies the level of the source of the EDI message. If it was generated by the payer, this field is a 1. If the message was generated by other than the payer, this field is null or 0. | |
| .1 | message date | 0;10 | DATE-TIME | AMD | This is the date and time when the message was generated. It will be taken from the return message transaction. | |
| .11 | update task | 0;11 | NUMERIC | This is the last Task Manager job that was entered for this transaction. | ||
| .12 | data base updated | 0;12 | BOOLEAN | 0:NO 1:YES | This is a flag that keeps track of whether or not this message has been applied against the data base and updated the appropriate statuses of the transmit bill and any other appropriate files. | |
| .13 | source | 0;13 | FREE TEXT | This is the text to identify who sent the message. | ||
| .14 | claim resubmitted test | 0;14 | BOOLEAN | 0:NO 1:YES | This is a flag that indicates if the status message is for a non-TEST claim, a test claim that was sent as TEST only or a live EDI claim that was resubmitted as a test claim. The first 2 instances will always have a 0 (NO) here, while the third instance will have a 1 (YES). | |
| 1.03 | status changed date | 1;3 | DATE-TIME | ASCD | This is the date and time that the status was last changed. | |
| 1.04 | status changed by | 1;4 | POINTER | 200 | The name of the person who last changed the status of this message. | |
| 2 | message | 2;0 | WORD-PROCESSING |