ra_835Import


Description

Remittance advice 835 import data storing electronic remittance advice information from insurance payers. This table captures detailed payment and adjustment information from EDI 835 transactions, including claim payments, denials, adjustments, and error codes, supporting automated payment posting and accounts receivable management for healthcare billing.

Columns

Column Type Size Nulls Auto Default Children Parents Comments
RAID int identity 4 √ null

Primary key - Unique identifier for each remittance advice import record
fkFileID int 4 √ null
raFiles.fileID FK_ra_835Import_raFiles R

File reference - Links to the remittance advice file that contained this record
InvoiceID nvarchar 40 √ null

Invoice identifier - Invoice ID from the remittance advice
IDValue nvarchar 100 √ null

Patient identifier value - Patient ID value from the remittance advice
DateService datetime 16,3 √ null

Service date - Date of service for the claim line
Status nvarchar 100 √ null

Claim status - Status of the claim line (Paid, Denied, Adjusted, etc.)
ChargeAmt money 21,4 √ null

Charge amount - Original amount charged for the service
PaidAmt money 21,4 √ null

Paid amount - Amount paid by the insurance for this service
PatientAmt money 21,4 √ null

Patient amount - Amount patient is responsible for (copay, deductible, etc.)
LastName nvarchar 100 √ null

Patient last name - Last name of the patient from the remittance advice
FirstName nvarchar 100 √ null

Patient first name - First name of the patient from the remittance advice
MiddleName nvarchar 100 √ null

Patient middle name - Middle name of the patient from the remittance advice
Error1 nvarchar 20 √ null

Error code 1 - First error or adjustment reason code
Error2 nvarchar 20 √ null

Error code 2 - Second error or adjustment reason code
Error3 nvarchar 20 √ null

Error code 3 - Third error or adjustment reason code
Error4 nvarchar 20 √ null

Error code 4 - Fourth error or adjustment reason code
Error5 nvarchar 20 √ null

Error code 5 - Fifth error or adjustment reason code
DateImport datetime 16,3 √ (getdate())

Import date - Date when this record was imported into the system
ICN varchar 30 √ null

Internal control number - Unique identifier for the claim from the payer
ProviderID varchar 20 √ null

Provider identifier - ID of the provider who rendered the service
ProcDesignation varchar 5 √ null

Procedure designation - Designation or modifier for the procedure code
AmtLineCharged money 21,4 √ null

Line charge amount - Amount charged for this specific line item
AmtLinePaid money 21,4 √ null

Line paid amount - Amount paid for this specific line item
Units decimal 12,2 √ null

Service units - Number of units of service provided
PriorAuth varchar 30 √ null

Prior authorization - Prior authorization number if applicable
AdjReason varchar 5 √ null

Adjustment reason - Reason code for any adjustments made
AmtLineAdjusted money 21,4 √ null

Line adjusted amount - Amount adjusted for this line item
claimid int 4 √ null

Internal claim reference - Links to the internal claim record if matched
AdjStatus varchar 5 √ null

Adjustment status - Status of any adjustments applied to this line
DocFileID varchar 30 √ null

Document file identifier - Reference to associated document file
LineNumber int 4 √ null

Line number - Line number within the claim for this service
DateBilled smalldatetime 16 √ null

Billing date - Date when the claim was originally billed
StatusFlag varchar 1 √ null

Status flag - Single character flag indicating processing status
Waiver varchar 1 √ null

Waiver indicator - Indicates if this service is covered under a waiver program
Code varchar 10 √ null

Procedure code - CPT or other procedure code for the service provided

Indexes

Constraint Name Type Sort Column(s)
PK_ra_835Import Primary key Asc RAID

Relationships

Close relationships within degrees of separation