BillingDenialCorrespondenc

This table contains Denial/Remark/Correspondence/Variance information from the Denial/Correspondence (BDC) master file. It includes information about the denial/remark code received or correspondence text as applicable. It also includes some general information about the current state of the record. It does not include the change history information and specific denial information from the explanation of benefits (EOB).

Column Name	Type	Description
DeploymentPhysicalOwnerIdentifier	VARCHAR	ID of the physical deployment owner for this record. Physical owners will be where the data is hosted, either on the cross-over server or the owner deployment.
IsInitialDenial	VARCHAR	Indicates if a denial is the first non-voided denial on a bucket (HB), or if it is the first non-voided denial from a payer for a charge (PB). If multiple denials were created on the same date, the initial denial is determined based on priority then denied amount.
DenialCorrespondenceSourceCategoryIdentifier	INTEGER	The source category ID for the Denial/Remark/Correspondence.
PayerDowngradeOutcome	INTEGER	Whether the primary payer's attempt to lower the level of care of the account via this BDC was appropriate and whether it was overturned or led to a downgrade. This item is null if no such attempt was made by the Primary Payer.
DenialResolutionOwnerUserId	VARCHAR	The user who should be credited with the resolution of the Denial/Correspondence record for purposes of productivity reporting.
VarianceOverrideAmount	NUMERIC	The variance amount for an imported overpayment/underpayment record.
ClaimExternalValueIdentification	NUMERIC	The Claim External Value ID of the Claim Print ID that was denied.
DenialReviewingAgency	INTEGER	This item stores the agency reviewing the denial (picked from a category list).
ExternalSystemPatientAdmitDate	DATETIME	This item is used to record the patient admit date if the record of the patient is in an external system.
IsAppealTextGeneratedByLlm	VARCHAR	Indicates whether a denial had appeals text generated in a LLM record.
DenialFinalDiagnosisRelatedGroupSeverityOfIllness	VARCHAR	The user recorded final DRG Severity of Illness (SOI) on the Denial/Correspondence record.
RemittanceCodeIdentifier	VARCHAR	The unique ID of the remittance code associated with the record.
OriginatingUserIdentifier	VARCHAR	The unique ID of the user that the denial/remark/correspondence record originated from. It is manually set in the update follow-up record feature of account maintenance liability buckets tab.
SystemCalculatedActualRecoveryAmount	NUMERIC	The actual recovery amount calculated by the system.
BillingSystemType	INTEGER	This item indicates if the BDC record is for Professional Billing, Hospital Billing, or both Professional Billing and Hospital Billing.
DenialCorrespondenceGuarantorIdentifier	NUMERIC	The unique ID of the guarantor associated with the denial/correspondence record.
DefaultClassificationRemarkCodeIdentifier	VARCHAR	Stores the highest priority associated remark code for denials if this remark was used to get default classification items. Default classification items include priority, preventable, owning area, source area, and code category.
AppealSubmissionDateTime	DATETIME	The date a given appeal was submitted to the payer or auditor.
DenialAppealStageNumber	INTEGER	The current level in the appeals process that the denial is in.
DenialSourceDepartmentIdentifier	NUMERIC	The unique ID of the department that caused the denial/remark/correspondence record. You manually set this item in the update follow-up record activity in the liability bucket info tab in account maintenance.
BillingDiagnosisRelatedGroupSeverityOfIllness	VARCHAR	The user recorded billing DRG Severity of Illness (SOI) on the Denial/Correspondence record.
InitialAppealDeadlineDate	DATETIME	This item stores the initial appeal deadline at the moment the BDC is created.
DenialSourceArea	INTEGER	This item stores the area that was the denial's source. This is populated automatically based on the original remittance code in item 90 or the reporting code in item 10124. It can also be manually overridden.
ActualRecoveryAmountUserEntered	NUMERIC	This item contains the amount actually paid as a result of resubmitting the claim associated with this denial. This can be overridden.
PatientAccountRecordStatus	INTEGER	The record status item specified in the Chronicles dictionary.
SourceHospitalBillingPaymentTransactionIdentifier	NUMERIC	ID of the Hospital Billing payment transaction that the denial/remark was linked to.
DenialReasonGroupCode	INTEGER	This item holds the group code associated with the reason code in a denial correspondence record.
DenialCorrespondenceRecordLastUpdateDateTime	DATETIME	The Date and time that the denial/correspondence record was updated.
SystemDeterminedDenialReason	INTEGER	This item stores the system determined root cause for a denial. Currently used only for PB Duplicate Denial Reason.
AppealResponseDueDate	DATETIME	The date an appeal response is due back to the payer or auditor.
DenialBenchmarkingClassification	INTEGER	The Epic-standard mapped denial classification used for benchmarking purposes.
DenialUserWriteOffAmount	NUMERIC	This item contains the amount of this denial that was written off.
DenialIsPreventableIndicator	VARCHAR	This item stores whether or not the denial could have been prevented by a user or a process. This is populated automatically based on the original remittance code in item RMC 127. It can also be manually overridden.
ExternalSystemClaimNumber	VARCHAR	This item is used to record the claim number if the record of the patient is in an external system.
RecordTypeCategoryIdentifier	INTEGER	The record type category ID for the Denial/Remark/Correspondence.
UserUpdateCount	INTEGER	Number of BDC updates performed by a user
DenialReviewingAgencyName	VARCHAR	This item stores the agency reviewing the denial.
DenialCorrespondenceRecordIdentifier	NUMERIC	The unique identifier for the denial/correspondence record.
DenialRecoveryMethod	INTEGER	This item stores how the denial was recovered.
ExternalPatientName	VARCHAR	This item is used to record the patient name if the record of the patient is in an external system.
DenialCorrespondenceRecordName	VARCHAR	BDC Record Name - Denial/Remark/Correspondence Record Name.
DenialRootCauseCategory	INTEGER	This item is used to record the root cause for the BDC correspondence.
ExternalSystemPatientDischargeDate	DATETIME	This item is used to record the patient discharge date if the record of the patient is in an external system.
PayerRecommendedDiagnosisRelatedGroup	VARCHAR	The user recorded payer recommended DRG from the payment that created the follow-up record.
DeniedDaysCount	INTEGER	Number of denied days represented by this denial.
CalculatedWriteOffAmount	NUMERIC	The write off amount entered by the user. If that is blank, this is the write off amount calculated by the system.
LiabilityBucketBalanceOnCreationDate	NUMERIC	This item is the balance on the liability bucket at the end of the day in which the Denial/Correspondence record was created.
PayerLevelOfCareDowngradeType	INTEGER	The type of downgrade requested via this BDC when the primary payer tries to dispute the level of care of the HAR.
HospitalLiabilityBucketIdentifier	NUMERIC	The Hospital Liability Bucket that the Denial/Remark/Correspondence record is linked to.
SystemCalculatedWriteOffAmount	NUMERIC	The write off amount calculated by the system.
InvoiceEndDate	DATETIME	Ending Date on the invoice linked to the denial/remark.
DenialCorrespondenceCompletionOrVoidDate	DATETIME	The date the Denial/Remark/Correspondence record was completed or voided.
ProfessionalBillingInvoiceIdentifier	NUMERIC	The professional invoice associated with the denial/correspondence record.
SourceProfessionalBillingPaymentTransactionIdentifier	NUMERIC	Professional Billing payment transaction which led to denial/correspondence record creation.
DeploymentLogicalOwnerIdentifier	VARCHAR	ID of the logical deployment owner for this record. Logical owners show the deployment where the record was created but doesn't represent if the record is a part of version skew.
RecordCreationDate	DATETIME	The date the Denial/Remark/Correspondence record was created.
IsRecordArchived	VARCHAR	Indicates whether the Denial/Remark/Correspondence record is archived at the record level.
FinalResolutionDiagnosisRelatedGroup	VARCHAR	The user recorded final resolution DRG.
DenialCorrespondenceRecordStatusCategoryId	INTEGER	The status category ID for the Denial/Remark/Correspondence.
ExpectedAllowedAmount	NUMERIC	Expected allowed amount on denial/remark/correspondence record.
DocumentInformationIdentifier	VARCHAR	The unique ID of the document that is associated with the denial/correspondence record.
DenialCorrespondenceReopenedDate	DATETIME	The date the Denial/Remark/Correspondence record was re-opened after being completed.
ExternalPatientBirthDate	DATETIME	This item is used to record the patient's date of birth if the record of the patient is in an external system.
DenialResolutionOwningArea	INTEGER	This item stores the area that is responsible for resolving the denial. This is populated automatically based on the original remittance code in item 124. It can also be manually overridden.
DenialPriorityNumber	NUMERIC	Current priority of the BDC record. A smaller number means a higher priority. An empty value will be considered as having the lowest priority.
AppealSubmissionMethodCode	INTEGER	The submission method used when submitting an appeal back to the payer or auditor.
CorrespondenceReceivedDate	DATETIME	The date the Denial/Remark/Correspondence was received.
AppealSubmittingUserIdentifier	VARCHAR	The user that submitted an appeal to the payer or auditor.
DenialResolutionComments	VARCHAR	Comments entered with resolution category.
DenialRemittanceExternalCode	VARCHAR	The external ID of the remittance code associated with this denial/correspondence.
DenialCorrespondenceRecordStage	INTEGER	This item is used to record the stage at which a particular BDC is.
DenialFollowUpDate	DATETIME	This date can be set when the status of a denial/correspondence is changed. Often used to populate a workqueue.
CalculatedActualRecoveryAmount	NUMERIC	The actual recovery amount entered by the user. If that is blank, this is the actual recovery amount calculated by the system.
DenialCreationDateInsuranceBalanceAmount	NUMERIC	This item is the outstanding insurance balance on the PB charges at the end of the day on which the denial record was created.
ReportedRemittanceCodeIdentifier	VARCHAR	This item stores the remit code for the system to report on.
BillingDiagnosisRelatedGroup	VARCHAR	This item stores the billing DRG sent on the claim or coded on the account. The billing DRG is looked up first from the claim and then from the account. It can be manually overridden.