Claim Book
Unique ID |
Matched Status |
MA Bill No |
Hospital |
Preauth Claim ID |
MRN |
Doctor |
Department |
Case ID |
First Name |
UTR Number |
Current WorkFlow State |
CG Bill Number |
Is Bulk Closure |
TPA Name |
Insurance Company Name |
TPA Member ID |
Insurance Policy Number |
Tracking Number |
AL Number |
CL Number |
Reconcilled Status |
Room Type |
Visit Type |
Courier Vendor |
Current Request Type |
DOA |
DOD |
Sent Date |
Received Date |
Paid On Date |
Claim Submitted Date |
Final Bill Date |
Is Admitted |
Case Closed In Preauth |
Current State Time |
Preauth Submitted Date Time |
Requested Amount |
Claim Amount |
Approved Amount |
Settled Amount |
TDS Amount |
TPA Shortfall Amount |
Final Bill Amount |
Forwarded To Claims Date |
Provisional Bill Amount |
Patient Paid |
Patient Payable |
Sub Date |
Remarks |
File Size |
Hash |
AL Key |
CL Key |
CG UTR Number |
CG Formatted UTR Number |
Final UTR Number |
CG Formatted Bill Number |
Raw Bill Number |