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ROW#1

 

 FIELD NAME

DEFINITIONS AND EXPLANATIONS

Claim Number

The first three digits refer to the year (204 = 2004). The next six digits identify the claim. The last two digits may have multiple meanings:

      • Because of the large number of claimed services, the original claim was split up to simplify processing; the first segment becomes -01, the second -02, etc.

      • The original claim (-00) was incorrectly processed and required revisions (beginning with -01).

 

Dates of Service From-Through

The first and last dates of the period over which a billed procedure that was performed or a billed service was delivered.

Group

All patients are associated with a group - this is typically an employer, but can also be a division or sub-division within the employer. Each group is identified by a unique code which is what you see here.

Social Security Number

The social security number of the "primary insured." Generally, this will be the social security number of the employee.

Status and Date

The current status of the claim and the date this status went into effect. Status options are: