| # | Name | Location | Type | Details | Index | Description |
|---|---|---|---|---|---|---|
| .01 | patient account number(+) | 0;1 | FREE TEXT | B | The PATIENT ACCOUNT NUMBER will be used as a look up to the BILL NO. field (#.01) in the ACCOUNTS RECEIVABLE file (#430). It is loaded as it is received from the Financial Services Center, FSC. | |
| .02 | medicare type | 0;2 | SET OF CODES | A:PART A | Medicare type to which the deductible applied. Currently only supporting Medicare Part A. It is loaded as it is received from the Financial Services Center, FSC. | |
| .03 | subscriber id (hicn) | 0;3 | FREE TEXT | This is the Medicare Assigned Member ID number. It is loaded as it is received from the Financial Services Center, FSC. | ||
| .04 | claim year | 0;4 | FREE TEXT | This is the 4 character year the deductible is applied against. It is loaded as it is received from the Financial Services Center, FSC. | ||
| .05 | dcn | 0;5 | FREE TEXT | This is the Document Control Number for this claim. It is loaded as it is received from the Financial Services Center, FSC. | ||
| .06 | cash deductible submitted | 0;6 | FREE TEXT | This is the Cash Deductible Submitted amount (DDDDCC) as it is received from the Financial Services Center, FSC. | ||
| .07 | cash deductible available | 0;7 | FREE TEXT | This is the Cash Deductible Available amount (DDDDCC) as it is received from the Financial Services Center, FSC. | ||
| .08 | service start date | 0;8 | DATE-TIME | This is the Service Start Date. It is received from the Financial Services Center (FSC) in the format CCYYMMDD, but converted and filed as a FileMan date. | ||
| .09 | service end date | 0;9 | DATE-TIME | This is the Service End Date. It is received from the Financial Services Center (FSC) in the format CCYYMMDD, but converted and filed as a FileMan date. | ||
| .1 | report date | 0;10 | DATE-TIME | This is the Report Date. It is received from the Financial Services Center (FSC) in the format CCYYMMDD, but converted and filed as a FileMan date. | ||
| 1.01 | bill no. | 1;1 | POINTER | 430 | C | The PATIENT ACCOUNT NUMBER will be used as a look up to the BILL NO. field (#.01) in the ACCOUNTS RECEIVABLE file (#430). |
| 1.02 | mda review status | 1;2 | SET OF CODES | 0:NOT REVIEWED 1:REVIEW IN PROCESS 2:REVIEW COMPLETE 3:REVIEW COMPLETE/REMOVE ENTRY | ||
| 1.03 | division | 1;3 | POINTER | 40.8 | This is the Medical Center Division to which this deductible was applied. It is retrieved using the Bill Number. | |
| 2 | comment date time | 2;0 | MULTIPLE | 436.12 | This multiple contains comments pertaining to the Medicare Deductible Alert received from the Financial Services Center, FSC. |
Not Referenced