ProfessionalBillingTransactionDetai
This table contains information about professional billing transactions.
| Column Name | Type | Description |
|---|---|---|
| PatientRecordIdentifier | VARCHAR | The internal identification number of the patient record with which the row's transaction has been associated. This field is always populated for charge transactions. |
| IsEstimatedPreServicePlanPaymentIndicator | VARCHAR | Indicates whether this payment was made on an estimated balance on a payment plan at time of filing ('Y'). 'N' or NULL indicates that the transaction is not a payment, the payment is not on a balance on a payment plan, or the balance was not estimated at the time of filing. |
| BenefitPackageIdentifier | NUMERIC | Stores the Benefit Package used to calculate the self-pay amount |
| ProviderLevelBalanceProviderIdentification | VARCHAR | PLB info: provider ID. |
| PatientResponsibilityAmount | NUMERIC | The patient or self-pay portion of the transaction. |
| ProcedureIdentification | NUMERIC | The Procedure ID of the procedure associated with the transaction. |
| TransactionCreditSourceModuleCode | INTEGER | The module that creates a payment or credit adjustment |
| TransactionFirstProcedureModifier | VARCHAR | The first procedure modifier associated with this transaction. This is the external modifier, as it would be printed on the claim. |
| TransactionSixthDiagnosisIdentifier | NUMERIC | The sixth diagnosis ID associated with the transaction. |
| BenefitsEngineAdjustedCoinsuranceAmount | NUMERIC | Stores the coinsurance part of the adjudicated self-pay amount calculated by the benefits engine |
| InsuranceBalanceWithoutFollowUpIndicator | VARCHAR | This flag is set for a charge if there is an insurance balance on the charge but (for the current coverage) no follow-up record is created and it is not in any claims queues. |
| RelativeValueUnitMalpracticeAmount | NUMERIC | The malpractice RVU associated with the transaction. |
| TransactionPostFiscalPeriod | VARCHAR | The fiscal period of the post date of the transaction. |
| TransactionProcedureQuantity | NUMERIC | The quantity as entered in Charge Entry for the procedure of this transaction (TX_ID). If the row has a DETAIL_TYPE value of 10-13, this column displays a negative value. If the row has a DETAIL_TYPE value of 20-33, 43-45, 50, or 51, this column displays a zero. |
| TransactionPrimaryDiagnosisIdentifier | NUMERIC | The primary diagnosis ID associated with the transaction. |
| AdjudicationFormulaIdentifier | NUMERIC | Stores a reference to the Adjudication Formula used to calculated the self-pay amount |
| RefundSourceCode | INTEGER | Refund source when printing refund slip. |
| DeprecatedVoidedCashTransferDirection | INTEGER | If this ETR represents a transaction that is represented in another service area or billing system, this item represents whether the cash backing this transaction has been transferred into or out of the current service area or billing system at the time that it was voided. |
| LeftForLaterDistributionIndicator | VARCHAR | This item stores the left for later distribution flag. This flag is set if a payment is a copay or a prepayment so that the system can try to automatically match the payment to subsequent charges that file. |
| AdvancedPricingComponentIndexIdentification | VARCHAR | Component or component group used in advanced pricing. |
| TotalMatchedAdjustmentAmount | NUMERIC | This column contains the total adjustment amount matched to the transaction. |
| ServicePerformedDate | DATETIME | The date a medical service is performed. |
| ProcedureModifierTwoCode | VARCHAR | The second procedure modifier associated with this transaction. This is the external modifier, as it would be printed on the claim. |
| DoNotBillInsuranceIndicator | VARCHAR | Indicates whether the transaction is marked for do not bill insurance. |
| AdvancedPricingMechanismCategory | INTEGER | Advanced pricing mechanism used. |
| OriginalPaymentInvoiceNumber | VARCHAR | This item stores the original invoice number that user posts to in GUI payment posting or remittance. |
| InsurancePaymentPostingAuthorizationNumber | VARCHAR | The authorization number entered in Insurance Payment Posting. |
| EncounterFormNumber | VARCHAR | The encounter form number corresponding to the charge transaction. If you are not using encounter forms, a negative number is stored in this item. |
| TransactionIdentificationNumber | NUMERIC | A transaction's unique internal identification number. A patient's record can include charges, payments, or adjustments and the patient's account balance will reflect these transactions. |
| SuspendedNextResponsiblePartyAssignmentActionValue | INTEGER | This column stores the assignment value for the suspended NRP action. |
| TransactionOverheadRelativeValueUnit | NUMERIC | The overhead RVU associated with the transaction. |
| BenefitsEngineAdjudicatedCopayAmount | NUMERIC | Stores the copay part of the adjudicated self-pay amount calculated by the benefits engine |
| ReferenceAmountOverride | NUMERIC | The reference amount override for a charge. The reference amount represents a pre-discounted charge rate. Some charge sources maintain their own pricing structure; for example, medications from Willow, supplies from OpTime, and some third-party charge sources will price charges within the charge generating application. This amount will file to the billing system and override any reference amount fee schedule build there. |
| HomeInfusionShipmentDate | DATETIME | The date the Home Infusion Shipment was sent to the patient. |
| SuspendedNonRemittanceProtocol | NUMERIC | This column stores the amount of the suspended NRP action. |
| MyChartLoginMethod | INTEGER | This column denotes how the patient or guarantor logged in to MyChart to either post the payment or create an agreement that will post a payment via Auto Pay. Only populated for agreements made via MyChart. |
| InstanceOwnerCommunityIdentifier | VARCHAR | The Community ID (CID) of the instance that owns this record or line. This is only populated if you use IntraConnect. |
| InsuranceAmount | NUMERIC | The insurance portion of the transaction. |
| TransactionServiceAreaIdentifier | NUMERIC | The service area ID of the service area associated with the transaction. |
| TransactionPaymentSourceCategory | INTEGER | This item stores the payment source for credit transactions. This is a list of possible sources including Cash, Check, Credit Card, etc. |
| TransactionPayorIdentifier | NUMERIC | This item stores the current payor (EPM) ID for this transaction. |
| TransactionProcedureCode | VARCHAR | The CPT code associated with the transaction. |
| IsConsumerSpendingAccountPayment | VARCHAR | Indicates that a payment was identified as coming from a consumer spending account during professional billing remittance processing. |
| BillForDenialCoverageIdentifier | NUMERIC | This item stores the coverage used to compute reimbursement and pricing contracts for charge lines that qualify for bill for denial workflows. |
| LastTransactionActionDate | DATETIME | This column contains the most recent date when an action is performed on this transaction. |
| TransactionLocationIdentifier | NUMERIC | The location ID of the location associated with the transaction. |
| IsFromSelfServiceWorkflow | VARCHAR | This column stores whether the self-pay payment was posted using a self-service workflow such as MyChart, Welcome, or Two-Way SMS. |
| TransactionHasZeroBalanceIndicator | VARCHAR | Indicates whether the transaction has a zero dollar balance. |
| LastUpdateDate | DATETIME | The date that this row was last updated. |
| TransactionSecondDiagnosisIdentifier | NUMERIC | The second diagnosis ID associated with the transaction. |
| ProviderLevelBalanceReferenceNumber | VARCHAR | PLB info: reference number. |
| MyChartAccountStatusForSelfPayPosting | INTEGER | This item contains either the status of the MyChart account that created the agreement that resulted in the self-pay payment (if applicable) or the status of the MyChart account that posted the self-pay payment. An active MyChart account status is defined as whether a MyChart user could log into the account with a user name and password. Accounts that are not yet active, deactivated, or are proxy accounts are considered inactive. |
| FacilityAcquisitionCost | NUMERIC | This item captures the facility's cost in acquiring or purchasing the charged item. This may not necessarily be the same cost the facility wishes to use for contract calculation purposes, which may include other overhead and markups. |
| TransactionLineAdjustmentReasonCode | VARCHAR | PLB info: reason code |
| TotalMatchedInsuranceAmount | NUMERIC | This column contains the total insurance amount matched to the transaction, including adjustments. |
| TransactionProviderSpecialty | VARCHAR | This column contains the provider specialty of the provider associated with the transaction. The procedure category of the charge on the transaction may affect what specialty is recorded here and in the "Encounter Specialty" displayed in Hyperspace. |
| AdjustmentDenialRecordIdentifier | NUMERIC | Stores the denial record associated with the transaction. Only applies to adjustments. |
| FourthProcedureModifier | VARCHAR | The fourth procedure modifier associated with this transaction. This is the external modifier, as it would be printed on the claim. |
| CommunityLogOwnerIdentifier | VARCHAR | The Community ID (CID) of the instance from which this record or line was extracted. This is only populated if you use IntraConnect. |
| TransactionAccountIdentifier | NUMERIC | The internal ID of the record that maintains the patient's transactions. A patient may use more than one account and an account may contain more than one patient. |
| AdvancedPricingFirstFeeScheduleIdentifier | NUMERIC | Fee schedule 1 used in advanced pricing. |
| ChargeEntryCodedDate | DATETIME | The date this charge session was coded, from charge entry. |
| SuspendedNextResponsiblePartySourceCoverageIdentifier | NUMERIC | This column stores the coverage when the next responsible party (NRP) action was suspended. |
| IsVideoVisitCharge | VARCHAR | Stores whether or not a given charge is a video visit charge |
| TransactionIdentifier | NUMERIC | The unique identifier for the transaction record. |
| FiscalPeriodDate | DATETIME | PLB info: fiscal period date. |
| ImpliedQuantityUnitCode | INTEGER | The implied quantity's unit. |
| AdvancedPricingSecondaryFeeScheduleIdentifier | NUMERIC | Fee schedule 2 used in advanced pricing. |
| TransactionPostDate | DATETIME | The date when a transaction is entered into the billing system. This differs from the service date, which is the date when the service was performed. |
| TransactionPlaceOfServiceIdentifier | NUMERIC | The place of service ID of the place of service associated with the transaction |
| ChargeEntryCoderUserIdentifier | VARCHAR | This item stores the coder that was entered on the transaction in charge entry. |
| PatientEncounterContactSerialNumber | NUMERIC | The Contact Serial Number for the patient encounter with which this transaction is associated. This number is unique across all patients and encounters in your system. |
| TransactionDepartmentIdentifier | NUMERIC | The department ID of the department associated with the transaction. |
| SuspendedNonRemittancePostingSourceModule | INTEGER | This column stores the module for the suspended NRP action. |
| IsCrossoverClaimPaymentCreditAdjustment | VARCHAR | Is this insurance payment or credit adjustment for a crossover claim? |
| StatementInterventionRuleIdentifier | VARCHAR | The unique ID of the rule which is violated by this transaction when screened for problems during statement processing. This column is frequently used to link to the CL_CHRG_EDIT_RULE table. |
| IntendedVisitHospitalAccountIdentifier | NUMERIC | A PB Visit account that is either associated with the patient encounter this transaction was collected for, shares a service date with this transaction, or is a fall back visit account created for future distribution. When this credit is distributed to a debit, if there is no undistributed amount remaining, that debit's HAR becomes the new Intended Visit Account HAR. In this way, a payment always has a visit to which it should be attributed. |
| SuspendedNonResponsePlanDestinationCoverageIdentifier | NUMERIC | This column stores the coverage for the suspended NRP action. |
| TransactionFourthDiagnosisIdentifier | NUMERIC | The fourth diagnosis ID associated with the transaction. |
| OriginatingServiceAreaIdentifier | NUMERIC | This is the source service area where this transaction originated. This is always the origin of the transaction and is copied when transactions sync back and forth across billing systems. |
| ConsolidatedSelfPayAccountRelationTypeCode | INTEGER | This column indicates if a professional billing transaction is related to consolidated balances. |
| CommunityLogOwnerIdentifier | VARCHAR | The Community ID (CID) of the instance from which this record or line was extracted. This is only populated if you use IntraConnect. |
| StatementWorkqueueIdentifier | NUMERIC | The unique ID of the account workqueue which is used to follow-up on the transactions excluded from the statement run. This column is frequently used to link to the ACCT_WQ table. |
| HomeInfusionTherapyEpisodeIdentifier | NUMERIC | The Home Infusion therapy episode |
| OriginalTransactionAmount | NUMERIC | The original amount of this transaction. |
| IsScannedCheckIndicator | VARCHAR | Indicates if a transaction was made using a scanned check. |
| TransactionDiscountTypeCategoryIdentifier | INTEGER | The discount type category ID for the transaction. |
| OverrideReimbursementContractDate | DATETIME | The contact that should be used of the override reimbursement contract that was entered. |
| TransactionSourceConsolidatedServiceAreaIdentifier | NUMERIC | In consolidated balances workflows, when a transaction is transferred to a target account that is synced from a different AR Source Service Area, this column points to the consolidated self-pay service area the transaction was transferred from. |
| TransactionOriginalFinancialClass | VARCHAR | This item stores the original financial class for this transaction. |
| TransactionBatchNumber | VARCHAR | This is the system batch number to which the transaction is posted. |
| AdjudicationTableIdentifier | NUMERIC | Stores a reference to the Adjudication Table used to calculate the self-pay amount |
| OriginalCoverageIdentifier | NUMERIC | This item stores the original coverage (CVG) ID for this transaction. |
| TransactionVisitNumber | VARCHAR | This item stores the visit number for this transaction. |
| TransactionThirdDiagnosisIdentifier | NUMERIC | The third diagnosis ID associated with the transaction. |
| TransactionThirdProcedureModifier</table> | VARCHAR | The third procedure modifier associated with this transaction. This is the external modifier, as it would be printed on the claim. |
| GuarantorMyChartAccountStatus | INTEGER | This column stores the MyChart account status for the guarantor at the time of patient posting. Only payments with cash records (CSH) or Auto Pay agreements (BSP) will have a value. An active MyChart account status is defined as whether a MyChart user could log into the account with a user name and password. Accounts that are not yet active, deactivated, or are proxy accounts are considered inactive. |
| TransactionCoverageIdentifier | NUMERIC | This item stores the current coverage (CVG) ID for this transaction. |
| BenefitComponentIdentification | VARCHAR | Stores a reference to the component (CMP) or component group (CMG) used to find the Adjudication Table for calculating the self-pay amount. This column links to both CL_CMP and CL_CMG. |
| TransactionTotalMatchedAmount | NUMERIC | This column contains the total amount matched to the transaction, including adjustments. |
| TransactionFacilityIdentifier | NUMERIC | This item stores the facility (EAF) ID for this transaction. |
| DiscountActivationRuleIdentifier | VARCHAR | Which Discount Determination rule was used to include the discount table. |
| SelfPayPaymentBreakdownCategory | INTEGER | This column stores the Self-Pay payment breakdown type category ID for a self-pay payment. This includes pre-service payments, Visit Auto Pay, payment plans (including pre-service vs. post-service and Auto Pay vs. manual). If the transaction is none of these, it defaults to "Previous Balance". Non self-pay payment transactions will have NULL for this column. |
| EnterprisePaymentHospitalTemporaryTransactionIdentifier | NUMERIC | The Enterprise payment hospital temporary transaction ID. |
| IsPreServiceEstimatePaymentPlanPaymentIndicator | VARCHAR | Indicates whether this payment was made toward a hospital account on a payment plan that was added by an estimate ('Y'). 'N' or NULL indicates that the transaction is not a payment or the payment was not made toward a hospital account on a payment plan that was added by an estimate. |
| AdvancedPricingFeeScheduleTwoPercent | NUMERIC | Percent of specified fee schedule 2 used in advanced pricing. |
| TransactionDebitCreditIndicator | INTEGER | This column contains a 1 if the transaction is a debit and a -1 if the transaction is a credit. A charge is always a debit, a payment is always a credit, and an adjustment can be either a debit or a credit. |
| AdvancedPricingLineDescription | VARCHAR | Description of the advanced pricing line in ECP used for this charge. |
| TransactionTotalRelativeValueUnits | NUMERIC | The total relative value units (RVU) associated with the transaction. |
| TransactionFeeScheduleIdentifier | NUMERIC | Contains the fee schedule which may have been attached to the associated discount table. |
| ServiceProvidingProviderIdentifier | VARCHAR | The internal identifier of the provider who performed the medical services on the patient. |
| IntendedVisitAccountCalculationMethod | INTEGER | The calculation method of the Intended Visit Account HAR. |
| PaymentPlanAgreementScheduledPaymentIdentifier | NUMERIC | The unique ID of the transaction's target guarantor's active payment plan agreement record at the time of filing. |
| AdvancedPricingPricingExtensionIdentifier | NUMERIC | Pricing extension used in advanced pricing. |
| CashTransferDirection | INTEGER | Related to Consolidated Self-Pay billing workflows, this column represents whether the cash backing this transaction has been transferred into or out of the current service area or billing system. |
| TransactionBillingAreaIdentifier | NUMERIC | Networked to BIL: the Bill Area for this transaction. |
| BenefitAdjudicationDeductibleAmount | NUMERIC | Stores the deductible portion of the adjudicated self-pay amount calculated by the benefits engine |
| CoverageAssignmentFlag | VARCHAR | This item stores the assignment flag for a coverage. This item is set to Yes if the charge is currently assigned to the payor in the PAYOR_ID column. |
| BenefitsEngineSelfPayAmount | NUMERIC | Stores the adjudicated self-pay amount calculated by the benefits engine |
| OriginalInvoiceIdentifier | NUMERIC | This item stores the original invoice ID that user posts to in graphical user interface (GUI) payment posting or remittance. |
| SuspendedNetRevenueProcessActionComment | VARCHAR | This column stores the comment for the suspended NRP action. |
| PatientPaymentCollectionWorkflowCategory | INTEGER | This column contains the workflow category ID performed to collect a patient payment from the point of view of the user. For example, MyChart eCheck-in vs. MyChart One-Touch. |
| ChargeImpliedQuantity | NUMERIC | The implied quantity for a charge. |
| TransactionPostedByUserIdentifier | VARCHAR | This item stores the user who posted the transaction. |
| TransactionWorkRelativeValueUnit | NUMERIC | The work RVU associated with the transaction. |
| IsRecordArchived | VARCHAR | Indicates whether the Professional Billing Transaction record is archived at the record level. |
| TransactionReferralIdentification | NUMERIC | This item stores the Referral (RFL) ID for this transaction. |
| TransactionBillingProviderIdentifier | VARCHAR | The billing provider associated with the transaction. |
| FifthDiagnosisIdentifier | NUMERIC | The fifth diagnosis ID associated with the transaction. |
| ChargeEntryBatchReceiveDate | DATETIME | This item stores the charge entry batch receive date. |
| StatementInterventionStatus | INTEGER | The statement intervention status category number which keeps track of whether the transaction has been through statement intervention or not. |
| PaymentCollectionUserID | VARCHAR | This column contains either the user who created the agreement that resulted in the payment (if applicable) or the user who posted the payment. This is only populated for self-pay payments. |