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Other Added - Medical Billing - DA1 Record Fields 15 Through 38
Upper Saddle River, N.J. - December 2004 - Compensation Resources, Inc. has released the results of its 2004 Year-End Compensation Survey. The purpose of this study was to obtain compensation data used for trending and planning purposes at companies of all sizes and shapes. Data was compiled from survey questions that were developed by CRI and distributed to companies in over 14 industrial classifications, in addition to Not-for-Profit organizations. The
DA1 field 31, positions 240 - 253, is the check trace number. This is just the number of the check so it can be tracked.
DA1 field 32, positions 254 - 261, is the check date. This is the date the check was written.
DA1 field 33, positions 262 - 270, is the amount paid to the provider, which is self explanatory.
DA1 field 34, positions 271 - 285, is the provider check trace number. Same explanation as field 31.
DA1 field 35, positions 286 - 293, is the provider check date. Same explanation as field 32.
DA1 field 36, positions 294 - 302, is the interest paid amount. This is any interest that needed to be paid on the claim
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DA1 field 15, position 156, is the zero payment indicator. This field is not currently supported by NSF 3.01 so there is no point in trying to explain what this means. Just more red tape for your claim approval. Hopefully, the day will never come when it is used.
DA1 fields, 16, 17 and 18, positions 157 - 162, are the adjudication indicators. This is more red tape, which unfortunately is used. Adjudication indicators are for claims that needed to be discussed, for lack of a better word. These are claims where it was not clearly determined that they would even be allowed to be submitted. An example of this would be some types of elective surgery that wasn't necessary. These indicators need to be sent in order to show the payer what factors were considered in sending this claim. If you don't quite understand all that, don't worry. Not many people do.
DA1 field 19, position 163, is the CHAMPUS branch. CHAMPUS is one of those health programs that deals with military personnel and family members of military personnel. The branch code is the branch of the military that the patient belongs to.
DA1 field 20, position 164, is the CHAMPUS sponsor grade. This is a fancy term for the military rank of the patient's sponsor.
DA1 field 21, position 165, is the CHAMPUS sponsor status. This is a code that tells what the sponsor's status in the military is, such as active, retired, etc.
DA1 field 22, positions 167 - 174, is the insurance card effective date. This is the actual date that the patient's insurance goes into effect. If the procedure is done before this date, there is a possibility that the claim will not be covered and paid.
DA1 field 23, positions 175 - 182, is the insurance card termination date. This is the date through which the patient's insurance is good. If the procedure is done after the insurance expires, there is a chance that the claim will also not be covered and paid.
DA1 field 24, positions 183 - 189, is the balance due amount. This is the amount that is still due to be paid on this claim.
DA1 fields 25 - 28, positions 190 - 221, are the EOMB or Explanation Of Medical Benefits dates, which is self explanatory.
DA1 field 29, positions 222 - 229, is the claim receipt date. This is the date that the claim is received by the payer, which should be the date of transmission.
DA1 field 30, positions 230 - 239, is the amount paid to beneficiary. This is any amount paid to the beneficiary.
DA1 field 31, positions 240 - 253, is the check trace number. This is just the number of the check so it can be tracked.
DA1 field 32, positions 254 - 261, is the check date. This is the date the check was written.
DA1 field 33, positions 262 - 270, is the amount paid to the provider, which is self explanatory.
DA1 field 34, positions 271 - 285, is the provider check trace number. Same explanation as field 31.
DA1 field 35, positions 286 - 293, is the provider check date. Same explanation as field 32.
DA1 field 36, positions 294 - 302, is the interest paid amount. This is any interest that needed to be paid on the claim.
The old adage 'the more things change the more they stay the same', is as true now as it ever was. A few weeks ago we heard on the news that a well known Telecoms' supplier was whingeing that they were victims of their own success. They had sold too many of a service and couldn't deliver the goods. Worse yet they could not supply the good customer services, to ensure client retention after the failures. The ensuing chaos led to more unhappiness with the sup
DA1 field 19, position 163, is the CHAMPUS branch. CHAMPUS is one of those health programs that deals with military personnel and family members of military personnel. The branch code is the branch of the military that the patient belongs to.
DA1 field 20, position 164, is the CHAMPUS sponsor grade. This is a fancy term for the military rank of the patient's sponsor.
DA1 field 21, position 165, is the CHAMPUS sponsor status. This is a code that tells what the sponsor's status in the military is, such as active, retired, etc.
DA1 field 22, positions 167 - 174, is the insurance card effective date. This is the actual date that the patient's insurance goes into effect. If the procedure is done before this date, there is a possibility that the claim will not be covered and paid.
DA1 field 23, positions 175 - 182, is the insurance card termination date. This is the date through which the patient's insurance is good. If the procedure is done after the insurance expires, there is a chance that the claim will also not be covered and paid.
DA1 field 24, positions 183 - 189, is the balance due amount. This is the amount that is still due to be paid on this claim.
DA1 fields 25 - 28, positions 190 - 221, are the EOMB or Explanation Of Medical Benefits dates, which is self explanatory.
DA1 field 29, positions 222 - 229, is the claim receipt date. This is the date that the claim is received by the payer, which should be the date of transmission.
DA1 field 30, positions 230 - 239, is the amount paid to beneficiary. This is any amount paid to the beneficiary.
DA1 field 31, positions 240 - 253, is the check trace number. This is just the number of the check so it can be tracked.
DA1 field 32, positions 254 - 261, is the check date. This is the date the check was written.
DA1 field 33, positions 262 - 270, is the amount paid to the provider, which is self explanatory.
DA1 field 34, positions 271 - 285, is the provider check trace number. Same explanation as field 31.
DA1 field 35, positions 286 - 293, is the provider check date. Same explanation as field 32.
DA1 field 36, positions 294 - 302, is the interest paid amount. This is any interest that needed to be paid on the claim
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DA1 field 21, position 165, is the CHAMPUS sponsor status. This is a code that tells what the sponsor's status in the military is, such as active, retired, etc.
DA1 field 22, positions 167 - 174, is the insurance card effective date. This is the actual date that the patient's insurance goes into effect. If the procedure is done before this date, there is a possibility that the claim will not be covered and paid.
DA1 field 23, positions 175 - 182, is the insurance card termination date. This is the date through which the patient's insurance is good. If the procedure is done after the insurance expires, there is a chance that the claim will also not be covered and paid.
DA1 field 24, positions 183 - 189, is the balance due amount. This is the amount that is still due to be paid on this claim.
DA1 fields 25 - 28, positions 190 - 221, are the EOMB or Explanation Of Medical Benefits dates, which is self explanatory.
DA1 field 29, positions 222 - 229, is the claim receipt date. This is the date that the claim is received by the payer, which should be the date of transmission.
DA1 field 30, positions 230 - 239, is the amount paid to beneficiary. This is any amount paid to the beneficiary.
DA1 field 31, positions 240 - 253, is the check trace number. This is just the number of the check so it can be tracked.
DA1 field 32, positions 254 - 261, is the check date. This is the date the check was written.
DA1 field 33, positions 262 - 270, is the amount paid to the provider, which is self explanatory.
DA1 field 34, positions 271 - 285, is the provider check trace number. Same explanation as field 31.
DA1 field 35, positions 286 - 293, is the provider check date. Same explanation as field 32.
DA1 field 36, positions 294 - 302, is the interest paid amount. This is any interest that needed to be paid on the claim
So you've got your drawings and design, your permits in hand, a pile of money lined up, your Contractor(s) reviewed and selected, and a gleam in your eye. Well, hang on! The most important step is yet to come before one nail hits the job. Now you have to decide how well you are going to REALLY limit your risk...The first concept to get your head firmly wrapped around is this:If you didn't get it in writing, it NEVER HAPPENEDnce is good. If the procedure is done after the insurance expires, there is a chance that the claim will also not be covered and paid.
DA1 field 24, positions 183 - 189, is the balance due amount. This is the amount that is still due to be paid on this claim.
DA1 fields 25 - 28, positions 190 - 221, are the EOMB or Explanation Of Medical Benefits dates, which is self explanatory.
DA1 field 29, positions 222 - 229, is the claim receipt date. This is the date that the claim is received by the payer, which should be the date of transmission.
DA1 field 30, positions 230 - 239, is the amount paid to beneficiary. This is any amount paid to the beneficiary.
DA1 field 31, positions 240 - 253, is the check trace number. This is just the number of the check so it can be tracked.
DA1 field 32, positions 254 - 261, is the check date. This is the date the check was written.
DA1 field 33, positions 262 - 270, is the amount paid to the provider, which is self explanatory.
DA1 field 34, positions 271 - 285, is the provider check trace number. Same explanation as field 31.
DA1 field 35, positions 286 - 293, is the provider check date. Same explanation as field 32.
DA1 field 36, positions 294 - 302, is the interest paid amount. This is any interest that needed to be paid on the claim
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DA1 field 31, positions 240 - 253, is the check trace number. This is just the number of the check so it can be tracked.
DA1 field 32, positions 254 - 261, is the check date. This is the date the check was written.
DA1 field 33, positions 262 - 270, is the amount paid to the provider, which is self explanatory.
DA1 field 34, positions 271 - 285, is the provider check trace number. Same explanation as field 31.
DA1 field 35, positions 286 - 293, is the provider check date. Same explanation as field 32.
DA1 field 36, positions 294 - 302, is the interest paid amount. This is any interest that needed to be paid on the claim.
DA1 field 37, positions 303 - 311, is the approved amount. This is the actual amount of the claim that was approved for payment.
DA1 field 38, positions 312 - 320 is filler national and must be left blank.
This concludes our review of medical billing claims for the DA1 provider record.
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