@vbasoftware/vbapi-vbasoftware-typescript-axios 1.20230208.2 → 1.20230403.1
This diff represents the content of publicly available package versions that have been released to one of the supported registries. The information contained in this diff is provided for informational purposes only and reflects changes between package versions as they appear in their respective public registries.
- package/.openapi-generator/FILES +19 -0
- package/api/adv-group-api.ts +17 -17
- package/api/chat-gptapi.ts +154 -0
- package/api/events-api.ts +87 -0
- package/api/groups-api.ts +17 -17
- package/api/prem-rate-types-api.ts +668 -0
- package/api/premium-invoice-payments-api.ts +124 -0
- package/api/premium-invoices-api.ts +336 -5
- package/api/premium-rate-distribution-types-api.ts +155 -0
- package/api/state-interest-api.ts +668 -0
- package/api/subscriber-plan-policies-api.ts +43 -91
- package/api/user-api.ts +394 -0
- package/api.ts +4 -0
- package/models/chat-message.ts +30 -0
- package/models/claim-batch-detail.ts +152 -140
- package/models/claim-batch.ts +1697 -479
- package/models/claim-detail.ts +137 -125
- package/models/claim-pre-batch-detail.ts +101 -95
- package/models/claim-pre-batch.ts +1703 -425
- package/models/claim.ts +1562 -338
- package/models/company-data.ts +433 -403
- package/models/cost-contain-zelis-ex-code.ts +12 -6
- package/models/enrollment-disenroll-group.ts +84 -0
- package/models/enrollment-disenroll.ts +28 -34
- package/models/groups.ts +18 -18
- package/models/idcard-request.ts +3 -3
- package/models/index.ts +15 -0
- package/models/mem-enrollment-plan.ts +9 -9
- package/models/mem-enrollment-rider.ts +10 -10
- package/models/member-beneficiary.ts +3 -3
- package/models/member-language.ts +38 -2
- package/models/member-medicare-resp.ts +50 -26
- package/models/members.ts +1 -1
- package/models/network-procedure-cluster.ts +15 -9
- package/models/plan-benefit-cluster.ts +12 -12
- package/models/plan-benefit-rate.ts +5 -5
- package/models/plan-benefits.ts +58 -52
- package/models/plan-type.ts +21 -21
- package/models/plans.ts +41 -41
- package/models/prem-invoice-group-summary-vbaresponse.ts +45 -0
- package/models/prem-invoice-group-summary.ts +114 -0
- package/models/prem-invoice-payment-ext-list-vbaresponse.ts +45 -0
- package/models/prem-invoice-payment-ext.ts +102 -0
- package/models/prem-invoice-slim-list-vbaresponse.ts +45 -0
- package/models/prem-invoice-slim.ts +42 -0
- package/models/prem-rate-type-list-vbaresponse.ts +45 -0
- package/models/prem-rate-type-vbaresponse.ts +45 -0
- package/models/prem-rate-type.ts +72 -0
- package/models/prem-rate.ts +91 -85
- package/models/state-interest-list-vbaresponse.ts +45 -0
- package/models/state-interest-vbaresponse.ts +45 -0
- package/models/state-interest.ts +84 -0
- package/models/sub-enrollment-plan.ts +10 -10
- package/models/sub-enrollment-rider.ts +14 -14
- package/models/subscribers.ts +2 -2
- package/models/user-reset-password-request.ts +42 -0
- package/models/users.ts +8 -8
- package/package.json +1 -1
|
@@ -21,841 +21,853 @@
|
|
|
21
21
|
*/
|
|
22
22
|
export interface ClaimBatchDetail {
|
|
23
23
|
/**
|
|
24
|
-
*
|
|
24
|
+
* References the ClaimBatch.Batch_Number value on the parent record. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
25
25
|
* @type {number}
|
|
26
26
|
* @memberof ClaimBatchDetail
|
|
27
27
|
*/
|
|
28
28
|
'batch_Number': number;
|
|
29
29
|
/**
|
|
30
|
-
*
|
|
30
|
+
* References the ClaimBatch.Batch_Claim value on the parent record. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
31
31
|
* @type {number}
|
|
32
32
|
* @memberof ClaimBatchDetail
|
|
33
33
|
*/
|
|
34
34
|
'batch_Claim': number;
|
|
35
35
|
/**
|
|
36
|
-
*
|
|
36
|
+
* In combination with Adjustment_Seq, creates a unique sequence for each service line on this claim.
|
|
37
37
|
* @type {string}
|
|
38
38
|
* @memberof ClaimBatchDetail
|
|
39
39
|
*/
|
|
40
40
|
'claim_Seq': string;
|
|
41
41
|
/**
|
|
42
|
-
*
|
|
42
|
+
* In combination with Claim_Seq, creates a unique sequence for each service line on this claim. Used to note adjustments, cascading, etc. when utlized.
|
|
43
43
|
* @type {string}
|
|
44
44
|
* @memberof ClaimBatchDetail
|
|
45
45
|
*/
|
|
46
46
|
'adjustment_Seq': string;
|
|
47
47
|
/**
|
|
48
|
-
*
|
|
48
|
+
* No longer in use.
|
|
49
49
|
* @type {string}
|
|
50
50
|
* @memberof ClaimBatchDetail
|
|
51
51
|
*/
|
|
52
52
|
'ansI_Code'?: string | null;
|
|
53
53
|
/**
|
|
54
|
-
*
|
|
54
|
+
* The APC code applied to this service if identified for calculation during adjudication.
|
|
55
55
|
* @type {string}
|
|
56
56
|
* @memberof ClaimBatchDetail
|
|
57
57
|
*/
|
|
58
58
|
'apC_Code'?: string | null;
|
|
59
59
|
/**
|
|
60
|
-
*
|
|
60
|
+
* For reference purposes, this hold the individual service line funding payor/account. If multiple payor/accounts are found on different service lines for the same claim, adjudication spits out an error.
|
|
61
61
|
* @type {number}
|
|
62
62
|
* @memberof ClaimBatchDetail
|
|
63
63
|
*/
|
|
64
64
|
'account_Key'?: number | null;
|
|
65
65
|
/**
|
|
66
|
-
*
|
|
66
|
+
* References the Adjustment_Seq value on the original claim that this claim is adjusting.
|
|
67
67
|
* @type {string}
|
|
68
68
|
* @memberof ClaimBatchDetail
|
|
69
69
|
*/
|
|
70
70
|
'adjusted_From_Adjustment_Line'?: string | null;
|
|
71
71
|
/**
|
|
72
|
-
*
|
|
72
|
+
* References the Claim_Seq value on the original claim that this claim is adjusting.
|
|
73
73
|
* @type {string}
|
|
74
74
|
* @memberof ClaimBatchDetail
|
|
75
75
|
*/
|
|
76
76
|
'adjusted_From_Line'?: string | null;
|
|
77
77
|
/**
|
|
78
|
-
*
|
|
78
|
+
* The Auth Number for services that require authorization. References Auth.Auth_Number.
|
|
79
79
|
* @type {string}
|
|
80
80
|
* @memberof ClaimBatchDetail
|
|
81
81
|
*/
|
|
82
82
|
'auth_Number'?: string | null;
|
|
83
83
|
/**
|
|
84
|
-
*
|
|
84
|
+
* If an Auth Penalty is applied during adjudication, that is housed here.
|
|
85
85
|
* @type {number}
|
|
86
86
|
* @memberof ClaimBatchDetail
|
|
87
87
|
*/
|
|
88
88
|
'auth_Penalty'?: number | null;
|
|
89
89
|
/**
|
|
90
|
-
*
|
|
90
|
+
* Notes that this service lines required authorization.
|
|
91
91
|
* @type {string}
|
|
92
92
|
* @memberof ClaimBatchDetail
|
|
93
93
|
*/
|
|
94
94
|
'auth_Required'?: string | null;
|
|
95
95
|
/**
|
|
96
|
-
*
|
|
96
|
+
* This is the benefit code assigned to this service line based on the Plan assigned on the Claim header. References BenefitCodes.Benefit_Code.
|
|
97
97
|
* @type {string}
|
|
98
98
|
* @memberof ClaimBatchDetail
|
|
99
99
|
*/
|
|
100
100
|
'benefit_Code'?: string | null;
|
|
101
101
|
/**
|
|
102
|
-
*
|
|
102
|
+
* Benefit Rate being applied to this detail line.
|
|
103
|
+
* @type {number}
|
|
104
|
+
* @memberof ClaimBatchDetail
|
|
105
|
+
*/
|
|
106
|
+
'benefit_Rate_Applied'?: number | null;
|
|
107
|
+
/**
|
|
108
|
+
* The billed charges assigned by the provider for this service. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
103
109
|
* @type {number}
|
|
104
110
|
* @memberof ClaimBatchDetail
|
|
105
111
|
*/
|
|
106
112
|
'billed_Price': number;
|
|
107
113
|
/**
|
|
108
|
-
*
|
|
114
|
+
* Pharmacy claim information submitted via file submission and used in reporting and interfaces.
|
|
109
115
|
* @type {string}
|
|
110
116
|
* @memberof ClaimBatchDetail
|
|
111
117
|
*/
|
|
112
118
|
'brand_Indicator'?: string | null;
|
|
113
119
|
/**
|
|
114
|
-
*
|
|
120
|
+
* For dental claims, notes if this surface had services rendered. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
115
121
|
* @type {boolean}
|
|
116
122
|
* @memberof ClaimBatchDetail
|
|
117
123
|
*/
|
|
118
124
|
'buccal': boolean;
|
|
119
125
|
/**
|
|
120
|
-
*
|
|
126
|
+
* No longer in use.
|
|
121
127
|
* @type {string}
|
|
122
128
|
* @memberof ClaimBatchDetail
|
|
123
129
|
*/
|
|
124
130
|
'cliA_Number'?: string | null;
|
|
125
131
|
/**
|
|
126
|
-
*
|
|
132
|
+
* Holds the Other Insurance calculated amount that would affect the payable amount for this service (calculated from COB_Hold, COB_Mem_Resp, COB_Savings, and COB_Savings_Used). Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
127
133
|
* @type {number}
|
|
128
134
|
* @memberof ClaimBatchDetail
|
|
129
135
|
*/
|
|
130
136
|
'coB_Amt': number;
|
|
131
137
|
/**
|
|
132
|
-
*
|
|
138
|
+
* Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied.
|
|
133
139
|
* @type {number}
|
|
134
140
|
* @memberof ClaimBatchDetail
|
|
135
141
|
*/
|
|
136
142
|
'coB_Hold'?: number | null;
|
|
137
143
|
/**
|
|
138
|
-
*
|
|
144
|
+
* Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied.
|
|
139
145
|
* @type {number}
|
|
140
146
|
* @memberof ClaimBatchDetail
|
|
141
147
|
*/
|
|
142
148
|
'coB_Mem_Resp'?: number | null;
|
|
143
149
|
/**
|
|
144
|
-
*
|
|
150
|
+
* Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied.
|
|
145
151
|
* @type {number}
|
|
146
152
|
* @memberof ClaimBatchDetail
|
|
147
153
|
*/
|
|
148
154
|
'coB_Savings'?: number | null;
|
|
149
155
|
/**
|
|
150
|
-
*
|
|
156
|
+
* Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied.
|
|
151
157
|
* @type {number}
|
|
152
158
|
* @memberof ClaimBatchDetail
|
|
153
159
|
*/
|
|
154
160
|
'coB_Savings_Used'?: number | null;
|
|
155
161
|
/**
|
|
156
|
-
*
|
|
162
|
+
* Used for Flex Claims to indicate the calendar year this claim applies.
|
|
157
163
|
* @type {string}
|
|
158
164
|
* @memberof ClaimBatchDetail
|
|
159
165
|
*/
|
|
160
166
|
'calendar_Year'?: string | null;
|
|
161
167
|
/**
|
|
162
|
-
*
|
|
168
|
+
* Notes if this service line is captiated. If the Claim.Capitation_Claim value is flagged, it overrides this value and notes the entire claim and all service lines as capitated. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
163
169
|
* @type {boolean}
|
|
164
170
|
* @memberof ClaimBatchDetail
|
|
165
171
|
*/
|
|
166
172
|
'capitation_Claim': boolean;
|
|
167
173
|
/**
|
|
168
|
-
*
|
|
174
|
+
* No longer in use.
|
|
169
175
|
* @type {number}
|
|
170
176
|
* @memberof ClaimBatchDetail
|
|
171
177
|
*/
|
|
172
178
|
'check_ID'?: number | null;
|
|
173
179
|
/**
|
|
174
|
-
*
|
|
180
|
+
* The co-insurance amount applied by adjudication based on benefit definition. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
175
181
|
* @type {number}
|
|
176
182
|
* @memberof ClaimBatchDetail
|
|
177
183
|
*/
|
|
178
184
|
'co_Ins_Amt': number;
|
|
179
185
|
/**
|
|
180
|
-
*
|
|
186
|
+
* The co-pay amount applied by adjudication based on benefit definition. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
181
187
|
* @type {number}
|
|
182
188
|
* @memberof ClaimBatchDetail
|
|
183
189
|
*/
|
|
184
190
|
'co_Pay_Amt': number;
|
|
185
191
|
/**
|
|
186
|
-
*
|
|
192
|
+
* For currency calculations, this holds the destination currency.
|
|
187
193
|
* @type {string}
|
|
188
194
|
* @memberof ClaimBatchDetail
|
|
189
195
|
*/
|
|
190
196
|
'currency_ID'?: string | null;
|
|
191
197
|
/**
|
|
192
|
-
*
|
|
198
|
+
* Pharmacy claim information submitted via file submission and used in reporting and interfaces.
|
|
193
199
|
* @type {number}
|
|
194
200
|
* @memberof ClaimBatchDetail
|
|
195
201
|
*/
|
|
196
202
|
'days_Supply'?: number | null;
|
|
197
203
|
/**
|
|
198
|
-
*
|
|
204
|
+
* If the service is eligiblity for deductible credits, they would be stored here.
|
|
199
205
|
* @type {number}
|
|
200
206
|
* @memberof ClaimBatchDetail
|
|
201
207
|
*/
|
|
202
208
|
'ded_Credit_Amt'?: number | null;
|
|
203
209
|
/**
|
|
204
|
-
*
|
|
210
|
+
* The deductible amount applied by adjudication based on benefit definition. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
205
211
|
* @type {number}
|
|
206
212
|
* @memberof ClaimBatchDetail
|
|
207
213
|
*/
|
|
208
214
|
'deductible_Amt': number;
|
|
209
215
|
/**
|
|
210
|
-
*
|
|
216
|
+
* The diagnosis pointer for this service line indicating which Diagnostic Codes from the Claim are applicable to this service.
|
|
211
217
|
* @type {string}
|
|
212
218
|
* @memberof ClaimBatchDetail
|
|
213
219
|
*/
|
|
214
220
|
'diagnosis_Code'?: string | null;
|
|
215
221
|
/**
|
|
216
|
-
*
|
|
222
|
+
* The difference between Billed and Allowed is stored as the Discount Amount. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
217
223
|
* @type {number}
|
|
218
224
|
* @memberof ClaimBatchDetail
|
|
219
225
|
*/
|
|
220
226
|
'discount_Amt': number;
|
|
221
227
|
/**
|
|
222
|
-
*
|
|
228
|
+
* Pharmacy claim information submitted via file submission and used in reporting and interfaces.
|
|
223
229
|
* @type {number}
|
|
224
230
|
* @memberof ClaimBatchDetail
|
|
225
231
|
*/
|
|
226
232
|
'dispense_As_Written'?: number | null;
|
|
227
233
|
/**
|
|
228
|
-
*
|
|
234
|
+
* For dental claims, notes if this surface had services rendered. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
229
235
|
* @type {boolean}
|
|
230
236
|
* @memberof ClaimBatchDetail
|
|
231
237
|
*/
|
|
232
238
|
'distal': boolean;
|
|
233
239
|
/**
|
|
234
|
-
*
|
|
240
|
+
* For RX claims or medical claims that hold a drug code. References DrugCode.Drug_Code.
|
|
235
241
|
* @type {string}
|
|
236
242
|
* @memberof ClaimBatchDetail
|
|
237
243
|
*/
|
|
238
244
|
'drug_Code'?: string | null;
|
|
239
245
|
/**
|
|
240
|
-
*
|
|
246
|
+
* Pharmacy claim information submitted via file submission and used in reporting and interfaces.
|
|
241
247
|
* @type {number}
|
|
242
248
|
* @memberof ClaimBatchDetail
|
|
243
249
|
*/
|
|
244
250
|
'drug_Quantity'?: number | null;
|
|
245
251
|
/**
|
|
246
|
-
*
|
|
252
|
+
* Date when the record was first added to the system.
|
|
247
253
|
* @type {string}
|
|
248
254
|
* @memberof ClaimBatchDetail
|
|
249
255
|
*/
|
|
250
256
|
'entry_Date'?: string;
|
|
251
257
|
/**
|
|
252
|
-
*
|
|
258
|
+
* User that first added the record to the system.
|
|
253
259
|
* @type {string}
|
|
254
260
|
* @memberof ClaimBatchDetail
|
|
255
261
|
*/
|
|
256
262
|
'entry_User'?: string | null;
|
|
257
263
|
/**
|
|
258
|
-
*
|
|
264
|
+
* During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
|
|
259
265
|
* @type {string}
|
|
260
266
|
* @memberof ClaimBatchDetail
|
|
261
267
|
*/
|
|
262
268
|
'error_Auth'?: string | null;
|
|
263
269
|
/**
|
|
264
|
-
*
|
|
270
|
+
* During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
|
|
265
271
|
* @type {string}
|
|
266
272
|
* @memberof ClaimBatchDetail
|
|
267
273
|
*/
|
|
268
274
|
'error_Benefit'?: string | null;
|
|
269
275
|
/**
|
|
270
|
-
*
|
|
276
|
+
* During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
|
|
271
277
|
* @type {string}
|
|
272
278
|
* @memberof ClaimBatchDetail
|
|
273
279
|
*/
|
|
274
280
|
'error_Count'?: string | null;
|
|
275
281
|
/**
|
|
276
|
-
*
|
|
282
|
+
* During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
|
|
277
283
|
* @type {string}
|
|
278
284
|
* @memberof ClaimBatchDetail
|
|
279
285
|
*/
|
|
280
286
|
'error_Covered'?: string | null;
|
|
281
287
|
/**
|
|
282
|
-
*
|
|
288
|
+
* During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
|
|
283
289
|
* @type {string}
|
|
284
290
|
* @memberof ClaimBatchDetail
|
|
285
291
|
*/
|
|
286
292
|
'error_Dates'?: string | null;
|
|
287
293
|
/**
|
|
288
|
-
*
|
|
294
|
+
* During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
|
|
289
295
|
* @type {string}
|
|
290
296
|
* @memberof ClaimBatchDetail
|
|
291
297
|
*/
|
|
292
298
|
'error_Diagnosis'?: string | null;
|
|
293
299
|
/**
|
|
294
|
-
*
|
|
300
|
+
* During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
|
|
295
301
|
* @type {string}
|
|
296
302
|
* @memberof ClaimBatchDetail
|
|
297
303
|
*/
|
|
298
304
|
'error_ExCode'?: string | null;
|
|
299
305
|
/**
|
|
300
|
-
*
|
|
306
|
+
* During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
|
|
301
307
|
* @type {string}
|
|
302
308
|
* @memberof ClaimBatchDetail
|
|
303
309
|
*/
|
|
304
310
|
'error_Modifier'?: string | null;
|
|
305
311
|
/**
|
|
306
|
-
*
|
|
312
|
+
* During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
|
|
307
313
|
* @type {string}
|
|
308
314
|
* @memberof ClaimBatchDetail
|
|
309
315
|
*/
|
|
310
316
|
'error_Place'?: string | null;
|
|
311
317
|
/**
|
|
312
|
-
*
|
|
318
|
+
* During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
|
|
313
319
|
* @type {string}
|
|
314
320
|
* @memberof ClaimBatchDetail
|
|
315
321
|
*/
|
|
316
322
|
'error_Price'?: string | null;
|
|
317
323
|
/**
|
|
318
|
-
*
|
|
324
|
+
* During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
|
|
319
325
|
* @type {string}
|
|
320
326
|
* @memberof ClaimBatchDetail
|
|
321
327
|
*/
|
|
322
328
|
'error_Procedure'?: string | null;
|
|
323
329
|
/**
|
|
324
|
-
*
|
|
330
|
+
* A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code.
|
|
325
331
|
* @type {string}
|
|
326
332
|
* @memberof ClaimBatchDetail
|
|
327
333
|
*/
|
|
328
334
|
'ex_Code'?: string | null;
|
|
329
335
|
/**
|
|
330
|
-
*
|
|
336
|
+
* A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code.
|
|
331
337
|
* @type {string}
|
|
332
338
|
* @memberof ClaimBatchDetail
|
|
333
339
|
*/
|
|
334
340
|
'ex_Code2'?: string | null;
|
|
335
341
|
/**
|
|
336
|
-
*
|
|
342
|
+
* A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code.
|
|
337
343
|
* @type {string}
|
|
338
344
|
* @memberof ClaimBatchDetail
|
|
339
345
|
*/
|
|
340
346
|
'ex_Code3'?: string | null;
|
|
341
347
|
/**
|
|
342
|
-
*
|
|
348
|
+
* The FICA tax amount for disability claims. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
343
349
|
* @type {number}
|
|
344
350
|
* @memberof ClaimBatchDetail
|
|
345
351
|
*/
|
|
346
352
|
'fica': number;
|
|
347
353
|
/**
|
|
348
|
-
*
|
|
354
|
+
* For dental claims, notes if this surface had services rendered. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
349
355
|
* @type {boolean}
|
|
350
356
|
* @memberof ClaimBatchDetail
|
|
351
357
|
*/
|
|
352
358
|
'facial': boolean;
|
|
353
359
|
/**
|
|
354
|
-
*
|
|
360
|
+
* Based on taxable amount and various configurations, this holds the Federal \"To Tax\" amount for disability claim.
|
|
355
361
|
* @type {number}
|
|
356
362
|
* @memberof ClaimBatchDetail
|
|
357
363
|
*/
|
|
358
364
|
'federal_Amount_To_Tax'?: number | null;
|
|
359
365
|
/**
|
|
360
|
-
*
|
|
366
|
+
* The calculated Federal tax amount based on the \"To Tax\" amount. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
361
367
|
* @type {number}
|
|
362
368
|
* @memberof ClaimBatchDetail
|
|
363
369
|
*/
|
|
364
370
|
'federal_Tax': number;
|
|
365
371
|
/**
|
|
366
|
-
*
|
|
372
|
+
* A flat federal tax amount applied in addition to the calculated tax amount.
|
|
367
373
|
* @type {number}
|
|
368
374
|
* @memberof ClaimBatchDetail
|
|
369
375
|
*/
|
|
370
376
|
'federal_Tax_Flat'?: number | null;
|
|
371
377
|
/**
|
|
372
|
-
*
|
|
378
|
+
* Pharmacy claim information submitted via file submission and used in reporting and interfaces.
|
|
373
379
|
* @type {string}
|
|
374
380
|
* @memberof ClaimBatchDetail
|
|
375
381
|
*/
|
|
376
382
|
'fill_Date'?: string | null;
|
|
377
383
|
/**
|
|
378
|
-
*
|
|
384
|
+
* Manually entered description of this flex claim.
|
|
379
385
|
* @type {string}
|
|
380
386
|
* @memberof ClaimBatchDetail
|
|
381
387
|
*/
|
|
382
388
|
'flex_Description'?: string | null;
|
|
383
389
|
/**
|
|
384
|
-
*
|
|
390
|
+
* Pharmacy claim information submitted via file submission and used in reporting and interfaces.
|
|
385
391
|
* @type {string}
|
|
386
392
|
* @memberof ClaimBatchDetail
|
|
387
393
|
*/
|
|
388
394
|
'formulary_Indicator'?: string | null;
|
|
389
395
|
/**
|
|
390
|
-
*
|
|
396
|
+
* For dental claims, notes if this surface had services rendered. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
391
397
|
* @type {boolean}
|
|
392
398
|
* @memberof ClaimBatchDetail
|
|
393
399
|
*/
|
|
394
400
|
'incisal': boolean;
|
|
395
401
|
/**
|
|
396
|
-
*
|
|
402
|
+
* If interest is calculated on a claim, it is stored here and applied to payable amount. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
397
403
|
* @type {number}
|
|
398
404
|
* @memberof ClaimBatchDetail
|
|
399
405
|
*/
|
|
400
406
|
'interest': number;
|
|
401
407
|
/**
|
|
402
|
-
*
|
|
408
|
+
* For dental claims, notes if this surface had services rendered. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
403
409
|
* @type {boolean}
|
|
404
410
|
* @memberof ClaimBatchDetail
|
|
405
411
|
*/
|
|
406
412
|
'labial': boolean;
|
|
407
413
|
/**
|
|
408
|
-
*
|
|
414
|
+
* The Life Benefit to be applied for Life claims processing.
|
|
409
415
|
* @type {string}
|
|
410
416
|
* @memberof ClaimBatchDetail
|
|
411
417
|
*/
|
|
412
418
|
'life_Benefit'?: string | null;
|
|
413
419
|
/**
|
|
414
|
-
*
|
|
420
|
+
* The Life Benefit calculated volume based on benefit definition.
|
|
415
421
|
* @type {number}
|
|
416
422
|
* @memberof ClaimBatchDetail
|
|
417
423
|
*/
|
|
418
424
|
'life_Benefit_Volume'?: number | null;
|
|
419
425
|
/**
|
|
420
|
-
*
|
|
426
|
+
* Number added manually to claims and from 837 files and sent outbound on 835 files.
|
|
421
427
|
* @type {string}
|
|
422
428
|
* @memberof ClaimBatchDetail
|
|
423
429
|
*/
|
|
424
430
|
'line_Control_Number'?: string | null;
|
|
425
431
|
/**
|
|
426
|
-
*
|
|
432
|
+
* For dental claims, notes if this surface had services rendered. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
427
433
|
* @type {boolean}
|
|
428
434
|
* @memberof ClaimBatchDetail
|
|
429
435
|
*/
|
|
430
436
|
'lingual': boolean;
|
|
431
437
|
/**
|
|
432
|
-
*
|
|
438
|
+
* If a locality tax is applicable it would be housed here.
|
|
433
439
|
* @type {number}
|
|
434
440
|
* @memberof ClaimBatchDetail
|
|
435
441
|
*/
|
|
436
442
|
'local_Tax'?: number | null;
|
|
437
443
|
/**
|
|
438
|
-
*
|
|
444
|
+
* Pharmacy claim information submitted via file submission and used in reporting and interfaces.
|
|
439
445
|
* @type {string}
|
|
440
446
|
* @memberof ClaimBatchDetail
|
|
441
447
|
*/
|
|
442
448
|
'mail_Order_Indicator'?: string | null;
|
|
443
449
|
/**
|
|
444
|
-
*
|
|
450
|
+
* Based on taxable amount and various configurations, this holds the Medicare \"To Tax\" amount for disability claim.
|
|
445
451
|
* @type {number}
|
|
446
452
|
* @memberof ClaimBatchDetail
|
|
447
453
|
*/
|
|
448
454
|
'medicare_Amount_To_Tax'?: number | null;
|
|
449
455
|
/**
|
|
450
|
-
*
|
|
456
|
+
* The calculated Medicare tax amount based on the \"To Tax\" amount.
|
|
451
457
|
* @type {number}
|
|
452
458
|
* @memberof ClaimBatchDetail
|
|
453
459
|
*/
|
|
454
460
|
'medicare_Tax'?: number | null;
|
|
455
461
|
/**
|
|
456
|
-
*
|
|
462
|
+
* For dental claims, notes if this surface had services rendered. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
457
463
|
* @type {boolean}
|
|
458
464
|
* @memberof ClaimBatchDetail
|
|
459
465
|
*/
|
|
460
466
|
'mesial': boolean;
|
|
461
467
|
/**
|
|
462
|
-
*
|
|
468
|
+
* This is for anesthesia, each Unit of anesthesia is equal to a specific amount of Minutes.
|
|
463
469
|
* @type {number}
|
|
464
470
|
* @memberof ClaimBatchDetail
|
|
465
471
|
*/
|
|
466
472
|
'minutes_Per_Unit'?: number | null;
|
|
467
473
|
/**
|
|
468
|
-
*
|
|
474
|
+
* The modifier applied to this service.
|
|
469
475
|
* @type {string}
|
|
470
476
|
* @memberof ClaimBatchDetail
|
|
471
477
|
*/
|
|
472
478
|
'modifier'?: string | null;
|
|
473
479
|
/**
|
|
474
|
-
*
|
|
480
|
+
* The modifier applied to this service.
|
|
475
481
|
* @type {string}
|
|
476
482
|
* @memberof ClaimBatchDetail
|
|
477
483
|
*/
|
|
478
484
|
'modifier_2'?: string | null;
|
|
479
485
|
/**
|
|
480
|
-
*
|
|
486
|
+
* The modifier applied to this service.
|
|
481
487
|
* @type {string}
|
|
482
488
|
* @memberof ClaimBatchDetail
|
|
483
489
|
*/
|
|
484
490
|
'modifier_3'?: string | null;
|
|
485
491
|
/**
|
|
486
|
-
*
|
|
492
|
+
* The modifier applied to this service.
|
|
487
493
|
* @type {string}
|
|
488
494
|
* @memberof ClaimBatchDetail
|
|
489
495
|
*/
|
|
490
496
|
'modifier_4'?: string | null;
|
|
491
497
|
/**
|
|
492
|
-
*
|
|
498
|
+
* The number of the units from this detail line that comes from the Modifier. This determines pricing for the line.
|
|
493
499
|
* @type {number}
|
|
494
500
|
* @memberof ClaimBatchDetail
|
|
495
501
|
*/
|
|
496
502
|
'modifier_Units'?: number | null;
|
|
497
503
|
/**
|
|
498
|
-
*
|
|
504
|
+
* For not covered services, or partially not covered services, this reflects that deduction. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
499
505
|
* @type {number}
|
|
500
506
|
* @memberof ClaimBatchDetail
|
|
501
507
|
*/
|
|
502
508
|
'not_Covered_Amt': number;
|
|
503
509
|
/**
|
|
504
|
-
*
|
|
510
|
+
* For dental claims, notes if this surface had services rendered. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
505
511
|
* @type {boolean}
|
|
506
512
|
* @memberof ClaimBatchDetail
|
|
507
513
|
*/
|
|
508
514
|
'occlusal': boolean;
|
|
509
515
|
/**
|
|
510
|
-
*
|
|
516
|
+
* For dental claims this holds the oral cavity designation sent on the 837D.
|
|
511
517
|
* @type {string}
|
|
512
518
|
* @memberof ClaimBatchDetail
|
|
513
519
|
*/
|
|
514
520
|
'oral_Cavity_Designation_Code_1'?: string | null;
|
|
515
521
|
/**
|
|
516
|
-
*
|
|
522
|
+
* For dental claims this holds the oral cavity designation sent on the 837D.
|
|
517
523
|
* @type {string}
|
|
518
524
|
* @memberof ClaimBatchDetail
|
|
519
525
|
*/
|
|
520
526
|
'oral_Cavity_Designation_Code_2'?: string | null;
|
|
521
527
|
/**
|
|
522
|
-
*
|
|
528
|
+
* For dental claims this holds the oral cavity designation sent on the 837D.
|
|
523
529
|
* @type {string}
|
|
524
530
|
* @memberof ClaimBatchDetail
|
|
525
531
|
*/
|
|
526
532
|
'oral_Cavity_Designation_Code_3'?: string | null;
|
|
527
533
|
/**
|
|
528
|
-
*
|
|
534
|
+
* For dental claims this holds the oral cavity designation sent on the 837D.
|
|
529
535
|
* @type {string}
|
|
530
536
|
* @memberof ClaimBatchDetail
|
|
531
537
|
*/
|
|
532
538
|
'oral_Cavity_Designation_Code_4'?: string | null;
|
|
533
539
|
/**
|
|
534
|
-
*
|
|
540
|
+
* For dental claims this holds the oral cavity designation sent on the 837D.
|
|
535
541
|
* @type {string}
|
|
536
542
|
* @memberof ClaimBatchDetail
|
|
537
543
|
*/
|
|
538
544
|
'oral_Cavity_Designation_Code_5'?: string | null;
|
|
539
545
|
/**
|
|
540
|
-
*
|
|
546
|
+
* Pharmacy claim information submitted via file submission and used in reporting and interfaces.
|
|
541
547
|
* @type {number}
|
|
542
548
|
* @memberof ClaimBatchDetail
|
|
543
549
|
*/
|
|
544
550
|
'other_Deduction_Amount'?: number | null;
|
|
545
551
|
/**
|
|
546
|
-
*
|
|
552
|
+
* Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
553
|
+
* @type {boolean}
|
|
554
|
+
* @memberof ClaimBatchDetail
|
|
555
|
+
*/
|
|
556
|
+
'override_Benefit_Code': boolean;
|
|
557
|
+
/**
|
|
558
|
+
* Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
547
559
|
* @type {boolean}
|
|
548
560
|
* @memberof ClaimBatchDetail
|
|
549
561
|
*/
|
|
550
562
|
'override_COB_Amt': boolean;
|
|
551
563
|
/**
|
|
552
|
-
*
|
|
564
|
+
* Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
553
565
|
* @type {boolean}
|
|
554
566
|
* @memberof ClaimBatchDetail
|
|
555
567
|
*/
|
|
556
568
|
'override_Co_Ins_Amt': boolean;
|
|
557
569
|
/**
|
|
558
|
-
*
|
|
570
|
+
* Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
559
571
|
* @type {boolean}
|
|
560
572
|
* @memberof ClaimBatchDetail
|
|
561
573
|
*/
|
|
562
574
|
'override_Co_Pay_Amt': boolean;
|
|
563
575
|
/**
|
|
564
|
-
*
|
|
576
|
+
* Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
565
577
|
* @type {boolean}
|
|
566
578
|
* @memberof ClaimBatchDetail
|
|
567
579
|
*/
|
|
568
580
|
'override_Ded_Credit_Amt': boolean;
|
|
569
581
|
/**
|
|
570
|
-
*
|
|
582
|
+
* Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
571
583
|
* @type {boolean}
|
|
572
584
|
* @memberof ClaimBatchDetail
|
|
573
585
|
*/
|
|
574
586
|
'override_Deductible_Amt': boolean;
|
|
575
587
|
/**
|
|
576
|
-
*
|
|
588
|
+
* Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
577
589
|
* @type {boolean}
|
|
578
590
|
* @memberof ClaimBatchDetail
|
|
579
591
|
*/
|
|
580
592
|
'override_Federal_Tax': boolean;
|
|
581
593
|
/**
|
|
582
|
-
*
|
|
594
|
+
* Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
583
595
|
* @type {boolean}
|
|
584
596
|
* @memberof ClaimBatchDetail
|
|
585
597
|
*/
|
|
586
598
|
'override_Local_Tax': boolean;
|
|
587
599
|
/**
|
|
588
|
-
*
|
|
600
|
+
* Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
589
601
|
* @type {boolean}
|
|
590
602
|
* @memberof ClaimBatchDetail
|
|
591
603
|
*/
|
|
592
604
|
'override_Medicare_Tax': boolean;
|
|
593
605
|
/**
|
|
594
|
-
*
|
|
606
|
+
* Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
595
607
|
* @type {boolean}
|
|
596
608
|
* @memberof ClaimBatchDetail
|
|
597
609
|
*/
|
|
598
610
|
'override_Not_Covered_Amt': boolean;
|
|
599
611
|
/**
|
|
600
|
-
*
|
|
612
|
+
* Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
601
613
|
* @type {boolean}
|
|
602
614
|
* @memberof ClaimBatchDetail
|
|
603
615
|
*/
|
|
604
616
|
'override_Plan_Price': boolean;
|
|
605
617
|
/**
|
|
606
|
-
*
|
|
618
|
+
* Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
607
619
|
* @type {boolean}
|
|
608
620
|
* @memberof ClaimBatchDetail
|
|
609
621
|
*/
|
|
610
622
|
'override_Social_Security': boolean;
|
|
611
623
|
/**
|
|
612
|
-
*
|
|
624
|
+
* Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
613
625
|
* @type {boolean}
|
|
614
626
|
* @memberof ClaimBatchDetail
|
|
615
627
|
*/
|
|
616
628
|
'override_State_Tax': boolean;
|
|
617
629
|
/**
|
|
618
|
-
*
|
|
630
|
+
* Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
619
631
|
* @type {boolean}
|
|
620
632
|
* @memberof ClaimBatchDetail
|
|
621
633
|
*/
|
|
622
634
|
'override_With_Hold_Amt': boolean;
|
|
623
635
|
/**
|
|
624
|
-
*
|
|
636
|
+
* Information field used in custom processing and reporting.
|
|
625
637
|
* @type {number}
|
|
626
638
|
* @memberof ClaimBatchDetail
|
|
627
639
|
*/
|
|
628
640
|
'ppO_Price_Plan_Price_Diff'?: number | null;
|
|
629
641
|
/**
|
|
630
|
-
*
|
|
642
|
+
* The final paid amount for this service line based on allowed amount (Plan_Price) minus all applicable deductions. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
631
643
|
* @type {number}
|
|
632
644
|
* @memberof ClaimBatchDetail
|
|
633
645
|
*/
|
|
634
646
|
'paid_Amt': number;
|
|
635
647
|
/**
|
|
636
|
-
*
|
|
648
|
+
* The partial loss amount for disability claims. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
637
649
|
* @type {number}
|
|
638
650
|
* @memberof ClaimBatchDetail
|
|
639
651
|
*/
|
|
640
652
|
'partial_Loss': number;
|
|
641
653
|
/**
|
|
642
|
-
*
|
|
654
|
+
* For reference purposes, this hold the individual service line funding payor/account. If multiple payor/accounts are found on different service lines for the same claim, adjudication spits out an error.
|
|
643
655
|
* @type {string}
|
|
644
656
|
* @memberof ClaimBatchDetail
|
|
645
657
|
*/
|
|
646
658
|
'payor_ID'?: string | null;
|
|
647
659
|
/**
|
|
648
|
-
*
|
|
660
|
+
* Pharmacy claim information submitted via file submission and used in reporting and interfaces.
|
|
649
661
|
* @type {string}
|
|
650
662
|
* @memberof ClaimBatchDetail
|
|
651
663
|
*/
|
|
652
664
|
'pharmacy_Name'?: string | null;
|
|
653
665
|
/**
|
|
654
|
-
*
|
|
666
|
+
* The place of service for the services being rendered on this service line.
|
|
655
667
|
* @type {string}
|
|
656
668
|
* @memberof ClaimBatchDetail
|
|
657
669
|
*/
|
|
658
670
|
'place_Of_Service'?: string | null;
|
|
659
671
|
/**
|
|
660
|
-
*
|
|
672
|
+
* The allowed amount for this service based on fee schedule, pricing, repricing, etc. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
661
673
|
* @type {number}
|
|
662
674
|
* @memberof ClaimBatchDetail
|
|
663
675
|
*/
|
|
664
676
|
'plan_Price': number;
|
|
665
677
|
/**
|
|
666
|
-
*
|
|
678
|
+
* The premium deduction amount for disability claims. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
667
679
|
* @type {number}
|
|
668
680
|
* @memberof ClaimBatchDetail
|
|
669
681
|
*/
|
|
670
682
|
'premium_Deduction': number;
|
|
671
683
|
/**
|
|
672
|
-
*
|
|
684
|
+
* Pharmacy claim information submitted via file submission and used in reporting and interfaces.
|
|
673
685
|
* @type {string}
|
|
674
686
|
* @memberof ClaimBatchDetail
|
|
675
687
|
*/
|
|
676
688
|
'prescriber_ID'?: string | null;
|
|
677
689
|
/**
|
|
678
|
-
*
|
|
690
|
+
* Pharmacy claim information submitted via file submission and used in reporting and interfaces.
|
|
679
691
|
* @type {string}
|
|
680
692
|
* @memberof ClaimBatchDetail
|
|
681
693
|
*/
|
|
682
694
|
'prescription_Date'?: string | null;
|
|
683
695
|
/**
|
|
684
|
-
*
|
|
696
|
+
* Pharmacy claim information submitted via file submission and used in reporting and interfaces.
|
|
685
697
|
* @type {string}
|
|
686
698
|
* @memberof ClaimBatchDetail
|
|
687
699
|
*/
|
|
688
700
|
'prescription_Number'?: string | null;
|
|
689
701
|
/**
|
|
690
|
-
*
|
|
702
|
+
* For reprice claims (typically submitted via 837), this notes the reprice method used to reprice this service line.
|
|
691
703
|
* @type {string}
|
|
692
704
|
* @memberof ClaimBatchDetail
|
|
693
705
|
*/
|
|
694
706
|
'pricing_Method'?: string | null;
|
|
695
707
|
/**
|
|
696
|
-
*
|
|
708
|
+
* The rate associated with the reprice method (Pricing_Method).
|
|
697
709
|
* @type {number}
|
|
698
710
|
* @memberof ClaimBatchDetail
|
|
699
711
|
*/
|
|
700
712
|
'pricing_Rate'?: number | null;
|
|
701
713
|
/**
|
|
702
|
-
*
|
|
714
|
+
* For life claims, this holds the principal amount for reporting. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
703
715
|
* @type {number}
|
|
704
716
|
* @memberof ClaimBatchDetail
|
|
705
717
|
*/
|
|
706
718
|
'principal': number;
|
|
707
719
|
/**
|
|
708
|
-
*
|
|
720
|
+
* The service being rendered on this claim.
|
|
709
721
|
* @type {string}
|
|
710
722
|
* @memberof ClaimBatchDetail
|
|
711
723
|
*/
|
|
712
724
|
'procedure_Code'?: string | null;
|
|
713
725
|
/**
|
|
714
|
-
*
|
|
726
|
+
* The secondary service being rendered on this claim.
|
|
715
727
|
* @type {string}
|
|
716
728
|
* @memberof ClaimBatchDetail
|
|
717
729
|
*/
|
|
718
730
|
'procedure_Code2'?: string | null;
|
|
719
731
|
/**
|
|
720
|
-
*
|
|
732
|
+
* The number of th eunits from this detail line that comes from the Prtocedure Code. This determines pricing for the line.
|
|
721
733
|
* @type {number}
|
|
722
734
|
* @memberof ClaimBatchDetail
|
|
723
735
|
*/
|
|
724
736
|
'procedure_Code_Units'?: number | null;
|
|
725
737
|
/**
|
|
726
|
-
*
|
|
738
|
+
* QPA (Qualified Payment Amount) values received in upcoming EDI transactions for the NSA (No Surprise Act) mandate.
|
|
727
739
|
* @type {number}
|
|
728
740
|
* @memberof ClaimBatchDetail
|
|
729
741
|
*/
|
|
730
742
|
'qualifying_Payment_Amount'?: number | null;
|
|
731
743
|
/**
|
|
732
|
-
*
|
|
744
|
+
* No longer in use.
|
|
733
745
|
* @type {number}
|
|
734
746
|
* @memberof ClaimBatchDetail
|
|
735
747
|
*/
|
|
736
748
|
'reason_Code'?: number | null;
|
|
737
749
|
/**
|
|
738
|
-
*
|
|
750
|
+
* Pharmacy claim information submitted via file submission and used in reporting and interfaces.
|
|
739
751
|
* @type {number}
|
|
740
752
|
* @memberof ClaimBatchDetail
|
|
741
753
|
*/
|
|
742
754
|
'refill_Indicator'?: number | null;
|
|
743
755
|
/**
|
|
744
|
-
*
|
|
756
|
+
* Holds the submitted reprice savings amount for services that include this amount in the pricing calculation.
|
|
745
757
|
* @type {number}
|
|
746
758
|
* @memberof ClaimBatchDetail
|
|
747
759
|
*/
|
|
748
760
|
'repriced_Savings_Amount'?: number | null;
|
|
749
761
|
/**
|
|
750
|
-
*
|
|
762
|
+
* For dental claims, notes if this surface had services rendered. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
751
763
|
* @type {boolean}
|
|
752
764
|
* @memberof ClaimBatchDetail
|
|
753
765
|
*/
|
|
754
766
|
'root': boolean;
|
|
755
767
|
/**
|
|
756
|
-
*
|
|
768
|
+
* The start date of the services being rendered.
|
|
757
769
|
* @type {string}
|
|
758
770
|
* @memberof ClaimBatchDetail
|
|
759
771
|
*/
|
|
760
772
|
'service_Date'?: string | null;
|
|
761
773
|
/**
|
|
762
|
-
*
|
|
774
|
+
* The end date of the services being rendered.
|
|
763
775
|
* @type {string}
|
|
764
776
|
* @memberof ClaimBatchDetail
|
|
765
777
|
*/
|
|
766
778
|
'service_Thru'?: string | null;
|
|
767
779
|
/**
|
|
768
|
-
*
|
|
780
|
+
* Based on taxable amount and various configurations, this holds the Social Security \"To Tax\" amount for disability claim.
|
|
769
781
|
* @type {number}
|
|
770
782
|
* @memberof ClaimBatchDetail
|
|
771
783
|
*/
|
|
772
784
|
'socSec_Amount_To_Tax'?: number | null;
|
|
773
785
|
/**
|
|
774
|
-
*
|
|
786
|
+
* The calculated Social Security tax amount based on the \"To Tax\" amount. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
775
787
|
* @type {number}
|
|
776
788
|
* @memberof ClaimBatchDetail
|
|
777
789
|
*/
|
|
778
790
|
'social_Security': number;
|
|
779
791
|
/**
|
|
780
|
-
*
|
|
792
|
+
* Based on taxable amount and various configurations, this holds the State \"To Tax\" amount for disability claim.
|
|
781
793
|
* @type {number}
|
|
782
794
|
* @memberof ClaimBatchDetail
|
|
783
795
|
*/
|
|
784
796
|
'state_Amount_To_Tax'?: number | null;
|
|
785
797
|
/**
|
|
786
|
-
*
|
|
798
|
+
* The calculated State tax amount based on the \"To Tax\" amount. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
787
799
|
* @type {number}
|
|
788
800
|
* @memberof ClaimBatchDetail
|
|
789
801
|
*/
|
|
790
802
|
'state_Tax': number;
|
|
791
803
|
/**
|
|
792
|
-
*
|
|
804
|
+
* A flat state tax amount applied in addition to the calculated tax amount.
|
|
793
805
|
* @type {number}
|
|
794
806
|
* @memberof ClaimBatchDetail
|
|
795
807
|
*/
|
|
796
808
|
'state_Tax_Flat'?: number | null;
|
|
797
809
|
/**
|
|
798
|
-
*
|
|
810
|
+
* When state taxes are calculated, this indicates the state the tax amount was calculated against.
|
|
799
811
|
* @type {string}
|
|
800
812
|
* @memberof ClaimBatchDetail
|
|
801
813
|
*/
|
|
802
814
|
'state_Tax_State'?: string | null;
|
|
803
815
|
/**
|
|
804
|
-
*
|
|
816
|
+
* Holds the individaul status of this service line based on Ex Codes. A - Payable, D - Denied, E - Pended.
|
|
805
817
|
* @type {string}
|
|
806
818
|
* @memberof ClaimBatchDetail
|
|
807
819
|
*/
|
|
808
820
|
'status_Code'?: string | null;
|
|
809
821
|
/**
|
|
810
|
-
*
|
|
822
|
+
* The units applied to this service.
|
|
811
823
|
* @type {number}
|
|
812
824
|
* @memberof ClaimBatchDetail
|
|
813
825
|
*/
|
|
814
826
|
'svc_Count'?: number | null;
|
|
815
827
|
/**
|
|
816
|
-
*
|
|
828
|
+
* This holds the starting taxable amount based on pre-tax and pre-gross deductions applied to this service.
|
|
817
829
|
* @type {number}
|
|
818
830
|
* @memberof ClaimBatchDetail
|
|
819
831
|
*/
|
|
820
832
|
'taxable_Amount'?: number | null;
|
|
821
833
|
/**
|
|
822
|
-
*
|
|
834
|
+
* For dental claims, this identifies the tooth, quadrant or arch being worked for this service.
|
|
823
835
|
* @type {number}
|
|
824
836
|
* @memberof ClaimBatchDetail
|
|
825
837
|
*/
|
|
826
838
|
'tooth_Number'?: number | null;
|
|
827
839
|
/**
|
|
828
|
-
*
|
|
840
|
+
* No longer in use. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
829
841
|
* @type {number}
|
|
830
842
|
* @memberof ClaimBatchDetail
|
|
831
843
|
*/
|
|
832
844
|
'ucR_Price': number;
|
|
833
845
|
/**
|
|
834
|
-
*
|
|
846
|
+
* Pharmacy claim information submitted via file submission and used in reporting and interfaces.
|
|
835
847
|
* @type {number}
|
|
836
848
|
* @memberof ClaimBatchDetail
|
|
837
849
|
*/
|
|
838
850
|
'unit_Dose'?: number | null;
|
|
839
851
|
/**
|
|
840
|
-
*
|
|
852
|
+
* Pharmacy claim information submitted via file submission and used in reporting and interfaces.
|
|
841
853
|
* @type {string}
|
|
842
854
|
* @memberof ClaimBatchDetail
|
|
843
855
|
*/
|
|
844
856
|
'unit_Of_Measure'?: string | null;
|
|
845
857
|
/**
|
|
846
|
-
*
|
|
858
|
+
* Date when the record was last updated in the system.
|
|
847
859
|
* @type {string}
|
|
848
860
|
* @memberof ClaimBatchDetail
|
|
849
861
|
*/
|
|
850
862
|
'update_Date'?: string;
|
|
851
863
|
/**
|
|
852
|
-
*
|
|
864
|
+
* User that last updated the record in the system.
|
|
853
865
|
* @type {string}
|
|
854
866
|
* @memberof ClaimBatchDetail
|
|
855
867
|
*/
|
|
856
868
|
'update_User'?: string | null;
|
|
857
869
|
/**
|
|
858
|
-
*
|
|
870
|
+
* For plans that allow withhold, this amount is used to track that amount. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
|
|
859
871
|
* @type {number}
|
|
860
872
|
* @memberof ClaimBatchDetail
|
|
861
873
|
*/
|