AIClaimSource_vw

Primary key - Claim unique identifier for each service billing record

Patient reference - Links to the patient who received the services (foreign key to Patient.PatientID)

Case reference - Links to the patient’s case administration record (foreign key to PatientAdministration.AdmitID)

Authorization reference - Links to the service authorization under which the claim was submitted (foreign key to Authorize.AuthID)

Patient name - Combined first and last name of the patient for identification and reporting

Patient status - Current status of the patient in the system (Active=receiving services, Inactive=services suspended, Discharged=services completed)

Case status - Current administrative status of the patient’s case, lookup reference to dbo.PatientStatus table (Open=active, Closed=completed, Pending=awaiting action)

EI Hub identifier - Each child has an ID assigned by EI, stored in dbo.PatientIDList table. EI Hub ID corresponds to IdTypeID = 14. Lookup ID types in ics2.dbo.PatientIDTypes table for cross-system patient tracking

Service provider - Name of the healthcare provider who delivered the service

Payment source - Paysource name representing the county or funding source (e.g., New York, Onondaga, Wayne). Lookup reference to dbo.PaymentSource_vw table

Provider supervisor - Name of the supervising professional overseeing the service provider

Service duration - Length of the service session in minutes for billing and documentation

Service date - Date when the healthcare service was actually delivered to the patient

Service start time - Time when the service session began

Service end time - Time when the service session concluded

Service type - Service name with lookup reference to ics2.dbo.ServiceType table (e.g., Speech Therapy, Physical Therapy)

Service modifier - Modifier name with lookup reference to ics2.dbo.Modifier table for additional service specification or billing modifier affecting reimbursement

Procedure code - Procedure name with lookup reference to ics2.dbo.ProcCode table, identifying the specific CPT or other procedure code for billing

Claim status - Claim status with lookup reference to ics2.dbo.StatusType table (Pending=awaiting review, Approved=ready for payment, Denied=rejected, Paid=payment issued)

Rule error code - Error of the claim with lookup reference to ics2.dbo.RuleError table, system-generated error code indicating billing rule violations or issues

Rule error description - Description of error with lookup reference to ics2.dbo.RuleError table, detailed explanation of the billing rule violation or processing issue

Claim type - Claim type with lookup reference to ics2.dbo.ClaimtypeInProgramType_vw (Evaluation=assessment, Treatment=therapy, Consultation=professional consultation)

Charged amount - Total amount billed to the payer for the service delivered

Outstanding balance - Amount still owed on the claim after payments and adjustments

Paid amount - Total amount received from the payer for this claim

Prior authorization - Authorization number required by the payer before service delivery

Voided amount - Amount that was voided or cancelled from the original claim

Void date - Date when the claim or portion of claim was voided

Billing units - Number of billable units claimed for the service (typically based on time or complexity)

Hold status - Whether the claim is on hold pending additional information (Yes=held, No=processing normally)

Form completion status - Whether all required documentation forms are completed (Yes=complete, No=missing forms)

Entry date - Date when the claim was entered into the billing system

Program name - Name of the service program with lookup reference to ics2.dbo.ProgramType table under which the claim was submitted

Invoice identifier - Reference number for the invoice containing this claim

Makeup date - Date when a makeup session was scheduled if the original session was missed

Group size - Number of patients in the session if delivered as a group service

Service setting - Location or environment where the service was delivered (Home, Clinic, School, etc.)

Service address - Physical address where the service was delivered

Service city - City where the service was delivered

Service ZIP code - Postal code of the service delivery location

Service location - Name of the facility or location where services were delivered

Provider rate - Hourly or per-unit rate paid to the service provider

Payroll status - Status of provider payment processing (Pending=awaiting payment, Paid=payment issued, Held=payment delayed)

Payroll export date - Date when the provider payment information was exported to payroll system

Profit margin - Calculated as AmountCharged minus PayrollRate, representing profit from the claim

Ordering provider - Healthcare professional who ordered or prescribed the service

CPT codes - Pulling data from dbo.ClaimCpt table. One claim has many CPTs. Using function dbo.getClaimCPTFullNames to get complete list of Current Procedural Terminology codes

ICD codes - Pulling data from ClaimIcd9 table. One claim has many ICDs. Using function dbo.getClaimICD9FullNames to get International Classification of Diseases codes indicating patient’s diagnosis

Visit code - Internal code and description with lookup reference to dbo.AttendanceCode_vw identifying the type of visit or session

Billable status - Whether the service is billable to insurance with lookup reference to dbo.AttCodeInClaimType (Yes=billable, No=non-billable)

Missed visit flag - If the VisitCode is matched on dbo.CancelledVisitCodes then showing Yes, else No. Indicates whether this represents a missed or cancelled visit