Claim

	Field	Type	Length	Description
1	Record Type ID	String		Indicates the record type. For this record it will always be “Claim”.
2	ID	ID		Surrogate Key
3	Patient ID	REF		Surrogate key to a patientCorresponds to a (Patient line in the same file set)’s ID value
4	Encounter ID	REF		Surrogate Key to an EncounterCorresponds to a (Encounter line in the same file set)’s ID value
5	Identifier	String	50	Claim identifier
6	MRN	String	50	Patient’s MRN
7	Start Date	Date
8	End Date	Date
9	Total Charges	Decimal	18
10	Total Paid	Decimal	18
11	Comment	String	MAX
12	Paid Date	String
13	Control Number	String	50
14	Admit Date	Date
15	Discharge Date	Date
16	Adjudication Date	Date
17	Admit Type Term	Term		code\|name\|namespace\|family\|ns desc.
18	Status Term	Term		code\|name\|namespace\|family\|ns desc
19	Bill Class Term	Term		code\|name\|namespace\|family\|ns desc
20	Insurance ID	REF		Surrogate Key to an InsuranceCorresponds to a (Insurance line in the same file set)’s ID value
21	Referral ID	REF		Placeholder for future version – Referrals not supported in this version.Surrogate Key to a ReferralCorresponds to a (Referral line in the same file set)’s ID value
22	Claim Type Term	Term		code\|name\|namespace\|family\|ns desc.
23	Facility Type Term	Term		code\|name\|namespace\|family\|ns desc.
24	Admit Source Term	Term		code\|name\|namespace\|family\|ns desc.
25	Patient Status Term	Term		code\|name\|namespace\|family\|ns desc.
26	Nonpayment reason Term	Term		code\|name\|namespace\|family\|ns desc.
27	Patient Identifier	String	50	Natural Key for existing patient. Part of Natural Key Identifier. Typically, the source’s or practice’s key Identifier for a patient
28	Patient Record Authority ID	REF		Surrogate Key to a Record Authority.
29	Encounter Identifier	String	128	Natural Key for existing encounter. Part of Natural Key Identifier. Typically, the source’s or practice’s key Identifier for an encounter
30	Insurance Plan Identifier	String	20	Part of Insurance Natural Key
31	Insurance Start Date	Date		Part of Insurance Natural Key
32	Referral Identifier	String	50	Part of Referral Natural Key
33	Referral Start Date	Date		Part of Referral Natural Key
34	Data Source Code	Data Source	50\|MAX	Code\|Name. See Data Source Format - Source of the data
35	Inserted Audit Data	Audit		Audit data for when the record was inserted/created
36	Last Modified Audit Data	Audit		Audit data for when the record was last modified
37	Total Patient Paid	Decimal
38	Alternate Identifier	String	100
39	DRG Term	Term		code\|name\|namespace\|family\|ns desc.
40	Disposition Term	Term		code\|name\|namespace\|family\|ns desc.