Claim

Authorization number - Prior authorization number if required for the service

Billed amount - Total amount billed for the services

Primary key - Claim unique identifier for each medical claim

Claim status - Current processing status (Submitted, Pending, Paid, Denied, etc.)

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

Service date - Date when the medical service was actually provided

Billing cycle date - Date indicating which billing cycle this claim belongs to for processing and reporting

Last update date - Date when the claim record was last modified or updated

Amount charged - Total amount charged for the services provided on this claim

Billing unit - Unit of measurement for billing calculations (hours, sessions, visits, etc.)

Agency reference - Reference to the healthcare agency that submitted this claim

Invoice identifier - Reference to the invoice that includes this claim for billing purposes

Patient reference - Reference to the patient who received the services

Claim type reference - Reference to the type of claim (evaluation, therapy, consultation, etc.)

Service site reference - Reference to the location where services were provided

Internal control number - Unique tracking number assigned by the clearinghouse for claim processing

Line number - Sequential line number for claims with multiple service lines

Entry user reference - Reference to the user who entered this claim into the system

Status reference - Reference to the current processing status of the claim

Amount paid - Actual amount paid by the insurance or payer for this claim

Payment date - Date when payment was received for this claim

Billing date - Date when this claim was submitted for billing

Action reference - Reference to the last action performed on this claim

Diagnosis code - Medical diagnosis code (ICD-10) supporting the medical necessity

Modifier reference - Reference to billing modifiers applied to this claim

Paid amount - Amount actually paid by the insurance or payer

Payer reference - Reference to the insurance company or payer organization

Place of service - Code indicating where the service was provided

Procedure code - Medical procedure code (CPT, HCPCS) for the service provided

Procedure reference - Reference to the procedure code for services provided

Service type reference - Reference to the type of service provided

Clearinghouse error reference - Reference to any errors reported by the billing clearinghouse

Rule error code - Error code indicating business rule violations or validation failures

Claim comments - Free-text comments or notes about this claim

Claim submitter reference - Reference to the user who submitted this claim for processing

Action date - Date when the last action was performed on this claim

Prior authorization - Prior authorization number or reference if required for this service

Provider reference - Reference to the healthcare provider who delivered the services

Remittance ID - Reference to the remittance advice document for payment details

Check number - Check number for payment received for this claim

Remittance advice ID - Reference to the electronic remittance advice record

Original billing date - Date when this claim was first submitted for billing

Active payroll reference - Reference to the payroll period when services were provided

PPD reference - Reference to provider payment data or payment processing details

Borough code - Geographic borough or district code for service location

Service units - Quantity or duration of services provided

Submission date - Date when the claim was submitted to the payer

Update user reference - Reference to the user who last updated this claim

Transaction type - Type of transaction (Original, Adjustment, Void, etc.)

Void reference - Reference to the voiding transaction if this claim was voided

Source system - Code indicating the source system or method used to create this claim

Transmission type - Method used to transmit this claim (Electronic, Paper, etc.)