STANDARD DATA DICTIONARY #344.4 -- ELECTRONIC REMITTANCE ADVICE FILE 3/24/25 PAGE 1
STORED IN ^RCY(344.4, *** NO DATA STORED YET *** SITE: WWW.BMIRWIN.COM UCI: VISTA,VISTA (VERSION 4.5)
DATA NAME GLOBAL DATA
ELEMENT TITLE LOCATION TYPE
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This file holds the ERA (Electronic Remittance Advice) information that is received electronically. It holds the summary for each
individual EOB (Explanation of Benefits) that comprise the ERA. Individual EOB detail data is found in file 361.1 in Integrated
Billing.
IDENTIFIED BY: TRACE NUMBER (#.02), ERA DATE (#.04), TOTAL AMOUNT PAID (#.05), PAYMENT FROM (#.06), EFT MATCH STATUS (#.09),
ERA DETAIL POST STATUS (#.14)
POINTED TO BY: ERA REFERENCE field (#.18) of the AR BATCH PAYMENT File (#344)
ERA RECORD field (#.1) of the EDI THIRD PARTY EFT DETAIL File (#344.31)
ERA REFERENCE field (#.01) of the EDI LOCKBOX EOB WORKLIST File (#344.49)
ERA TOTALS RECORD field (#.07) of the AR EDI LOCKBOX MESSAGES File (#344.5)
ERA # field (#.03) of the RCDPE AUTO-POST AUDIT File (#344.72)
ERA field (#95) of the AR TRANSACTION File (#433)
CROSS
REFERENCED BY: ERA DATE(AC), REMOVED DATE(AD), EOB DETAIL(ADET), ERROR CATEGORY(AEXC), FILE DATE/TIME(AFD),
DATE/TIME ERA LINKED(AFL), EFT MATCH STATUS(AMATCH), MARK FOR AUTO-POST(AP), RECEIPT(AREC),
TRANSFERRED DATE(ATOUT), ENTRY(B), AUTO-POST STATUS(E), AUTO-POST DATE(F), AUTO-DECREASE DATE(G), RECEIPT(H),
INSURANCE CO ID(I), MCCF DATE/TIME(MCCF)
INDEXED BY: ENTRY & TRACE NUMBER & INSURANCE CO ID & ERA DATE & TOTAL AMOUNT PAID & PAYMENT FROM & FILE DATE/TIME & RECEIPT &
EFT MATCH STATUS & INDIVIDUAL EOB COUNT & CHECK # & ERA DETAIL POST STATUS & REMOVED DATE & ERA LINKED BY (AMCCF),
PAYMENT FROM & INSURANCE CO ID (APT), RECEIPT (ARCT), INSURANCE CO ID & PAYMENT FROM (ATP), TRACE NUMBER & INSURANCE
CO ID (ATRID), TRACE NUMBER & INSURANCE CO ID (ATRIDUP), PAYMENT FROM (C), TRACE NUMBER (D), TRACE NUMBER (DNLZ)
LAST MODIFIED: DEC 18,2023@14:44:32
344.4,.01 ENTRY 0;1 NUMBER (Required)
INPUT TRANSFORM: K:+X'=X!(X>9999999999)!(X<1)!(X?.E1"."1N.N) X I $D(X) S DINUM=X
LAST EDITED: MAY 16, 2018
HELP-PROMPT: Type a Number between 1 and 9999999999, 0 Decimal Digits
DESCRIPTION: This field contains a sequential number generated at the time a record is stored in the file. It
only serves to create an entry in the file and has no other special meaning.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
CROSS-REFERENCE: 344.4^B
1)= S ^RCY(344.4,"B",$E(X,1,30),DA)=""
2)= K ^RCY(344.4,"B",$E(X,1,30),DA)
CROSS-REFERENCE: ^^TRIGGER^344.4^.14
1)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^RCY(344.4,D0,0)):^(0),1:"") S X=$P(Y(1),U,14),X=X S
DIU=X K Y S X=DIV S X=0 S DIH=$G(^RCY(344.4,DIV(0),0)),DIV=X S $P(^(0),U,14)=DIV,DIH=344.4,DIG=.14
D ^DICR
2)= Q
3)= Do not delete
CREATE VALUE)= S X=0
DELETE VALUE)= NO EFFECT
FIELD)= DETAIL POST STATUS
RECORD INDEXES: AMCCF (#828)
344.4,.02 TRACE NUMBER 0;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>50!($L(X)<3) X
LAST EDITED: OCT 01, 2014
HELP-PROMPT: Answer must be 3-50 characters in length.
DESCRIPTION: This is the bank trace number assigned to the ERA received. If the ERA was paid by paper check,
this should be the check #.
FIELD INDEX: D (#981) REGULAR IR LOOKUP & SORTING
Short Descr: REGULAR INDEX
Description: This cross-reference is used to look up an ERA by its full trace number.
Set Logic: S ^RCY(344.4,"D",$E(X,1,50),DA)=""
Kill Logic: K ^RCY(344.4,"D",$E(X,1,50),DA)
Whole Kill: K ^RCY(344.4,"D")
X(1): TRACE NUMBER (344.4,.02) (Subscr 1) (Len 50) (forwards)
FIELD INDEX: DNLZ (#1212) MUMPS IR LOOKUP & SORTING
Short Descr: Cross-ref. TRACE # without leading zeroes.
Description: This cross-reference is used to lookup an ERA by its trace number without leading zeroes and to
allow partial matches for numeric trace numbers. The "D" cross-reference is used for the full trace
number. "NLZ" means "No Leading Zeroes", hence "DNLZ" for this cross-reference.
After the leading zeroes are removed a space (" ") is appended to the cross-referenced value for
collation purposes. This cross-reference is only SET or KILLed for TRACE # entries that are
numeric or those with leading zeroes and numerics.
A trace number such as "000345678" is stored as "345678 ", "001 " as "1 ",and "1234" as "1234 ".
Trace numbers such as "000","0000","00000", etc. are stored as "0 ".
Although the TRACE # field is supposed to be a minimum of 3 characters, this logic is designed to
handle invalid values in this field.
Set Logic: Q:'(X?.N!($E(X)=0)) N RC S RC=X X:$E(X)=0&($L(X)>2) "F S RC=$E(RC,2,$L(RC)) Q:$L(RC)<2!'($E(RC)=0
)" S ^RCY(344.4,"DNLZ",RC_" ",DA)=""
Kill Logic: Q:'(X?.N!($E(X)=0)) N RC S RC=X X:$E(X)=0&($L(X)>2) "F S RC=$E(RC,2,$L(RC)) Q:$L(RC)<2!'($E(RC)=0
)" K ^RCY(344.4,"DNLZ",RC_" ",DA)
Whole Kill: K ^RCY(344.4,"DNLZ")
X(1): TRACE NUMBER (344.4,.02) (Subscr 1) (Len 50) (forwards)
RECORD INDEXES: AMCCF (#828), ATRID (#292), ATRIDUP (#403)
344.4,.03 INSURANCE CO ID 0;3 FREE TEXT (Required)
INPUT TRANSFORM: K:$L(X)>30!($L(X)<1) X
LAST EDITED: NOV 17, 2017
HELP-PROMPT: Answer must be 1-30 characters in length.
DESCRIPTION: This is the insurance co's electronic ID that will be recorded on each ERA received at the site.
This field, along with the trace number should always be unique in this file.
CROSS-REFERENCE: 344.4^I
1)= S ^RCY(344.4,"I",$E(X,1,30),DA)=""
2)= K ^RCY(344.4,"I",$E(X,1,30),DA)
3)= Do not Delete
This is a search index on INSURANCE CO ID field, reports against the ERA file use a lookup based on
INSURANCE CO ID, this index will reduce the time to generate ad-hoc reports.
RECORD INDEXES: AMCCF (#828), APT (#1526), ATP (#1527), ATRID (#292), ATRIDUP (#403)
344.4,.04 ERA DATE 0;4 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: SEP 29, 2011
HELP-PROMPT: Enter the date from the ERA record.
DESCRIPTION:
This is the date the ERA was generated by the payer.
CROSS-REFERENCE: 344.4^AC
1)= S ^RCY(344.4,"AC",$E(X,1,30),DA)=""
2)= K ^RCY(344.4,"AC",$E(X,1,30),DA)
3)= DO NOT DELETE
This cross-reference is used by the option 'Mark ERAs Returned to Payer Audit Report'.
RECORD INDEXES: AMCCF (#828)
344.4,.05 TOTAL AMOUNT PAID 0;5 NUMBER
INPUT TRANSFORM: S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>999999999999)!(X<0) X
LAST EDITED: SEP 24, 2002
HELP-PROMPT: Type a Dollar Amount between 0 and 999999999999, 2 Decimal Digits
DESCRIPTION:
This is the total amount of all the individual EOB records included in the ERA.
RECORD INDEXES: AMCCF (#828)
344.4,.06 PAYMENT FROM 0;6 FREE TEXT
INPUT TRANSFORM: K:$L(X)>60!($L(X)<1) X
MAXIMUM LENGTH: 60
LAST EDITED: NOV 17, 2017
HELP-PROMPT: Answer must be 1-60 characters in length.
DESCRIPTION:
This is the name of the insurance co as returned on the ERA.
FIELD INDEX: C (#404) MUMPS IR LOOKUP & SORTING
Short Descr: Used to look up entries by the full payer name.
Description: This cross-reference is used for payer names of up to 60 characters.
Do not delete this cross-reference.
Set Logic: S ^RCY(344.4,"C",$$UP^XLFSTR($E(X,1,60)),DA)=""
Kill Logic: K ^RCY(344.4,"C",$$UP^XLFSTR($E(X,1,60)),DA)
Whole Kill: K ^RCY(344.4,"C")
X(1): PAYMENT FROM (344.4,.06) (Subscr 1) (Len 60) (forwards)
RECORD INDEXES: AMCCF (#828), APT (#1526), ATP (#1527)
344.4,.07 FILE DATE/TIME 0;7 DATE
INPUT TRANSFORM: S %DT="ESTXR" D ^%DT S X=Y K:Y<1 X
LAST EDITED: JAN 21, 2004
HELP-PROMPT: Enter the date/time the ERA was filed in VistA.
DESCRIPTION:
This is the date/time the ERA was filed in VistA.
CROSS-REFERENCE: 344.4^AFD
1)= S ^RCY(344.4,"AFD",$E(X,1,30),DA)=""
2)= K ^RCY(344.4,"AFD",$E(X,1,30),DA)
3)= Do not delete
Created to find entries to include on ERA worklist pick list.
RECORD INDEXES: AMCCF (#828)
344.4,.08 RECEIPT 0;8 POINTER TO AR BATCH PAYMENT FILE (#344)
LAST EDITED: APR 06, 2004
HELP-PROMPT: Enter the receipt that this ERA detail is contained in.
DESCRIPTION:
This is the receipt created to record the detail of the ERA for AR posting.
NOTES: TRIGGERED by the RECEIPT # field of the AR BATCH PAYMENT File
CROSS-REFERENCE: 344.4^AREC
1)= S ^RCY(344.4,"AREC",$E(X,1,30),DA)=""
2)= K ^RCY(344.4,"AREC",$E(X,1,30),DA)
3)= Do not delete
CROSS-REFERENCE: ^^TRIGGER^344.49^.02
1)= Q
2)= X ^DD(344.4,.08,1,2,2.3) I X S X=DIV S I(0,0)=$G(D0),D0=D0 S:'D0!'$D(^RCY(344.49,+D0,0)) D0=-1
S DIV(0)=D0,Y(101)=$S($D(^RCY(344.49,D0,0)):^(0),1:"") S X=$P($G(^RCY(344,+$P(Y(101),U,2),0)),U),D0
=I(0,0),DIU=X K Y S X="" X ^DD(344.4,.08,1,2,2.4)
2.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$S($D(^RCY(344.4,D0,0)):^(0),1:"") S X=$P($G(^R
CY(344,+$P(Y(1),U,8),0)),U)=""
2.4)= S DIH=$G(^RCY(344.49,DIV(0),0)),DIV=X I $D(^(0)) S $P(^(0),U,2)=DIV,DIH=344.49,DIG=.02 D ^DIC
R
3)= Do not delete
CREATE VALUE)= NO EFFECT
DELETE CONDITION)= RECEIPT=""
DELETE VALUE)= @
FIELD)= EDI LOCKBOX EOB WORKLIST:RECEIPT
FIELD INDEX: ARCT (#291) REGULAR IR SORTING ONLY
Short Descr: Cross reference by AR receipt #
Set Logic: S ^RCY(344.4,"ARCT",X,DA)=""
Kill Logic: K ^RCY(344.4,"ARCT",X,DA)
Whole Kill: K ^RCY(344.4,"ARCT")
X(1): RECEIPT (344.4,.08) (Subscr 1) (forwards)
RECORD INDEXES: AMCCF (#828)
344.4,.09 EFT MATCH STATUS 0;9 SET
'0' FOR UNMATCHED;
'-1' FOR MATCHED WITH ERRORS;
'1' FOR MATCHED;
'2' FOR MATCHED TO PAPER CHECK;
'3' FOR MATCH-0 PAYMENT;
'4' FOR REMOVED FROM WORKLIST;
'5' FOR MATCHED TO TDA;
LAST EDITED: JAN 12, 2022
HELP-PROMPT: Enter the status to indicate if the ERA has been matched
DESCRIPTION: This is the status that indicates whether or not the ERA has been matched to an electronic EFT
record or TDA. If the total amt of the EFT payment does not equal the total amount of the ERA
payment, the status will be -1 (MATCHED WITH ERRORS). If the ERA has a 0-payment and no EFT or
check, the status will be 3 (MATCH-0 PAYMENT) and if matched to a paper check, the status will be 2
(MATCHED TO PAPER CHECK). If the ERA has been removed from the worklist the status will be 4
(REMOVED FROM WORKLIST). If the ERA has been matched to a TDA, the status will be 5 (MATCHED TO A
TDA).
CROSS-REFERENCE: 344.4^AMATCH
1)= S ^RCY(344.4,"AMATCH",$E(X,1,30),DA)=""
2)= K ^RCY(344.4,"AMATCH",$E(X,1,30),DA)
3)= Do not delete
This xref allows easy access to unmatched or mismatched ERA records.
RECORD INDEXES: AMCCF (#828)
344.4,.1 ERA TYPE 0;10 SET
'0' FOR MRA;
'1' FOR ERA;
LAST EDITED: DEC 06, 2002
HELP-PROMPT: Enter a 0 if this is an ERA from MEDICARE (MRA)
DESCRIPTION: This is the field that will designate whether the ERA is from an insurance company or from MEDICARE
via the MRA requests.
344.4,.11 INDIVIDUAL EOB COUNT 0;11 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: SEP 17, 2002
HELP-PROMPT: Type a Number between 0 and 999, 0 Decimal Digits
DESCRIPTION:
This field contains the total # of EOB detail records included in the ERA.
NOTES: TRIGGERED by the SEQUENCE # field of the ERA DETAIL sub-field of the ELECTRONIC REMITTANCE ADVICE
File
RECORD INDEXES: AMCCF (#828)
344.4,.12 MAIL MESSAGE 0;12 FREE TEXT
INPUT TRANSFORM: K:$L(X)>60!($L(X)<1) X
LAST EDITED: JAN 14, 2003
HELP-PROMPT: Answer must be 1-60 characters in length.
DESCRIPTION:
This is the list of message #s where the original ERA was received, separated by commas.
344.4,.13 CHECK # 5;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>50!($L(X)<1) X
LAST EDITED: JAN 12, 2022
HELP-PROMPT: Answer must be 1-50 characters in length.
DESCRIPTION: This is the # of the paper check that was received for payment of this ERA. NOTE: If the EFT MATCH
STATUS is 5 (MATCHED TO TDA), this field is null.
RECORD INDEXES: AMCCF (#828)
344.4,.14 ERA DETAIL POST STATUS 0;14 SET
'0' FOR NOT POSTED;
'1' FOR POSTED;
'2' FOR MANUALLY POSTED;
'3' FOR POSTING NOT NEEDED;
'4' FOR NOT POSTED-REMOVED;
'5' FOR PARTIAL;
LAST EDITED: MAR 07, 2014
HELP-PROMPT: Enter the code that corresponds to whether or not the ERA detail was posted and if so, if it was
manually posted.
DESCRIPTION: This is a flag that indicates whether or not the receipt for the ERA has been posted. It is used
to limit the choices when selecting ERAs for the ERA Worklist option.
NOTES: TRIGGERED by the ENTRY field of the ELECTRONIC REMITTANCE ADVICE File
RECORD INDEXES: AMCCF (#828)
344.4,.15 EXPECTED PAYMENT METHOD CODE 0;15 FREE TEXT
INPUT TRANSFORM: K:$L(X)>3!($L(X)<1) X
LAST EDITED: SEP 12, 2003
HELP-PROMPT: Answer must be 1-3 characters in length.
DESCRIPTION:
This is the code that indicates the method of payemnt that can be expected as a result of this ERA.
344.4,.16 REMOVED BY 6;1 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: JAN 24, 2012
HELP-PROMPT: Select the person who removed the ERA from the EEOB worklist.
DESCRIPTION:
This field is used to record the person who removed the ERA from the EEOB worklist.
344.4,.17 REMOVED DATE 6;2 DATE
INPUT TRANSFORM: S %DT="EST" D ^%DT S X=Y K:Y<1 X
LAST EDITED: JAN 17, 2012
HELP-PROMPT: Enter the Date/time the ERA was removed.
DESCRIPTION:
This field records the date/time that the ERA was removed from the EEOB worklist.
CROSS-REFERENCE: 344.4^AD
1)= S ^RCY(344.4,"AD",$E(X,1,30),DA)=""
2)= K ^RCY(344.4,"AD",$E(X,1,30),DA)
3)= DO NOT DELETE
This cross-reference is used by the option 'Mark ERAs Returned to Payer Audit Report'.
RECORD INDEXES: AMCCF (#828)
344.4,.18 REMOVE REASON 6;3 FREE TEXT (Required)
INPUT TRANSFORM: K:$L(X)>60!($L(X)<5) X
MAXIMUM LENGTH: 60
LAST EDITED: OCT 26, 2022
HELP-PROMPT: Answer must be 5-60 characters in length.
DESCRIPTION:
The justification for removing the ERA from the EEOB worklist.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
344.4,.19 AUTO-DECREASE BLOCKED 6;4 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: FEB 09, 2018
HELP-PROMPT: Enter YES if the ERA should not be auto-decreased.
DESCRIPTION: This field is used to determine if a zero balance denial ERA with payment type of 'NON' should be
blocked from auto-decrease in the PRCA Nightly Process.
TECHNICAL DESCR: This field is set manually in the ERA Worklist if an ERA has auto-decrease CARCs but the user
decides to block auto-decrease of these CARCS.
344.4,1 ERA DETAIL 1;0 Multiple #344.41 (Add New Entry without Asking)
LAST EDITED: AUG 12, 2003
DESCRIPTION: This subfile contains the list of individual EOBs that were processed in this ERA from a single
payer.
INDEXED BY: SEQUENCE # & EOB DETAIL & AMOUNT PAID & RECEIPT & ERROR STATUS & AUTO-DECREASE AMOUNT & AUTO-POST
DATE & AUTO-DECREASE DATE (AMCCF), MCCF DATE/TIME (AMCCF1), EOB DETAIL & INVALID BILL NUMBER (AVAL)
344.41,.01 SEQUENCE # 0;1 NUMBER (Required) (Multiply asked)
INPUT TRANSFORM: K:+X'=X!(X>99999999)!(X<0)!(X?.E1"."1.N) X I $D(X) S DINUM=X
LAST EDITED: JUL 15, 2020
HELP-PROMPT: Type a number between 0 and 99999999, 0 Decimal Digits
DESCRIPTION:
This is a sequence # used internally to identify this ERA detail record.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
CROSS-REFERENCE: 344.41^B
1)= S ^RCY(344.4,DA(1),1,"B",$E(X,1,30),DA)=""
2)= K ^RCY(344.4,DA(1),1,"B",$E(X,1,30),DA)
CROSS-REFERENCE: ^^TRIGGER^344.4^.11
1)= K DIV S DIV=X,D0=DA(1),DIV(0)=D0,D1=DA S Y(1)=$S($D(^RCY(344.4,D0,0)):^(0),1:"") S X=$P(Y(1),U,
11),X=X S DIU=X K Y S X=DIV S X=DIU+1 S DIH=$G(^RCY(344.4,DIV(0),0)),DIV=X S $P(^(0),U,11)=DIV,DIH=
344.4,DIG=.11 D ^DICR
2)= K DIV S DIV=X,D0=DA(1),DIV(0)=D0,D1=DA S Y(1)=$S($D(^RCY(344.4,D0,0)):^(0),1:"") S X=$P(Y(1),U,
11),X=X S DIU=X K Y S X=DIV S X=DIU-1 S DIH=$G(^RCY(344.4,DIV(0),0)),DIV=X S $P(^(0),U,11)=DIV,DIH=
344.4,DIG=.11 D ^DICR
3)= Do not delete
CREATE VALUE)= INDIVIDUAL EOB COUNT+1
DELETE VALUE)= INDIVIDUAL EOB COUNT-1
FIELD)= INDIVIDUAL EOB COUNT
Keeps track of the number of individual EOBs in the EOB transmission.
RECORD INDEXES: AMCCF (#845)
344.41,.02 EOB DETAIL 0;2 POINTER TO EXPLANATION OF BENEFITS FILE (#361.1)
INPUT TRANSFORM:S DIC("S")="I '$P(^(0),U,4)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
LAST EDITED: NOV 25, 2002
HELP-PROMPT: Enter the EOB detail records that will comprise the EOB record
DESCRIPTION:
The detail EOB records that comprise the 835 transaction.
SCREEN: S DIC("S")="I '$P(^(0),U,4)"
EXPLANATION: This can only be regular EOB's, not MRA's
CROSS-REFERENCE:344.41^AC
1)= S ^RCY(344.4,DA(1),1,"AC",$E(X,1,30),DA)=""
2)= K ^RCY(344.4,DA(1),1,"AC",$E(X,1,30),DA)
3)= Do not delete
CROSS-REFERENCE:344.4^ADET
1)= S ^RCY(344.4,"ADET",$E(X,1,30),DA(1),DA)=""
2)= K ^RCY(344.4,"ADET",$E(X,1,30),DA(1),DA)
3)= Do not delete
Cross references entire file by EOB detail pointer to file 361.1
RECORD INDEXES: AMCCF (#845), AVAL (#293)
344.41,.03 AMOUNT PAID 0;3 NUMBER
INPUT TRANSFORM:S:X["$" X=$P(X,"$",2) K:X'?."-".N.1".".2N!(X>9999999999999)!(X<-9999999999999) X
LAST EDITED: FEB 13, 2003
HELP-PROMPT: Type a Dollar Amount between -9999999999999 and 9999999999999, 2 Decimal Digits
DESCRIPTION:
This is the specific amount the payer has paid on this bill.
RECORD INDEXES: AMCCF (#845)
344.41,.04 INSURANCE COMPANY ON BILL 0;4 POINTER TO INSURANCE COMPANY FILE (#36)
LAST EDITED: AUG 27, 2003
HELP-PROMPT: Enter the name of the insurance co who supplied this EOB data
DESCRIPTION:
This is the insurance company that supplied this EOB data
344.41,.05 INVALID BILL NUMBER 0;5 FREE TEXT
INPUT TRANSFORM:K:$L(X)>20!($L(X)<1) X
LAST EDITED: APR 09, 2003
HELP-PROMPT: Answer must be 1-20 characters in length.
DESCRIPTION:
This is the bill # received on the EOB, but it doesn't exist in VistA.
CROSS-REFERENCE:344.41^AD
1)= S ^RCY(344.4,DA(1),1,"AD",$E(X,1,30),DA)=""
2)= K ^RCY(344.4,DA(1),1,"AD",$E(X,1,30),DA)
3)= Do not delete
CROSS-REFERENCE:^^TRIGGER^344.41^.17
1)= Q
2)= X ^DD(344.41,.05,1,2,2.3) I X S X=DIV S Y(1)=$S($D(^RCY(344.4,D0,1,D1,0)):^(0),1:"") S X=$P(Y(1
),U,17),X=X S DIU=X K Y X ^DD(344.41,.05,1,2,2.1) X ^DD(344.41,.05,1,2,2.4)
2.1)= S X=DIV S Y(1)=$S($D(^RCY(344.4,D0,1,D1,0)):^(0),1:"") S X=$P(Y(1),U,5)
2.3)= K DIV S DIV=X,D0=DA(1),DIV(0)=D0,D1=DA,DIV(1)=D1 S Y(0)=X S Y(1)=$S($D(^RCY(344.4,D0,1,D1,0))
:^(0),1:"") S X=$P(Y(1),U,17)=""
2.4)= S DIH=$G(^RCY(344.4,DIV(0),1,DIV(1),0)),DIV=X S $P(^(0),U,17)=DIV,DIH=344.41,DIG=.17 D ^DICR
3)= Do not delete
CREATE VALUE)= NO EFFECT
DELETE CONDITION)= BILL NUMBER FROM PAYER=""
DELETE VALUE)= INVALID BILL NUMBER
FIELD)= BILL NUMBER FROM PAYER
RECORD INDEXES: AVAL (#293)
344.41,.07 ERROR CATEGORY 0;7 SET
'1' FOR VALID BILL NOT FOUND;
'2' FOR EOB DETAIL NOT IN IB;
'99' FOR OTHER;
LAST EDITED: DEC 23, 2002
HELP-PROMPT: Enter the # corresponding to the specific error detected
DESCRIPTION: This field is used to categorize the specific errors associated with EOB detail records. This is
the coded error for special exception processing.
CROSS-REFERENCE:344.4^AEXC
1)= S ^RCY(344.4,"AEXC",$E(X,1,30),DA(1),DA)=""
2)= K ^RCY(344.4,"AEXC",$E(X,1,30),DA(1),DA)
This xref is used to identify EOB records with exception conditions.
344.41,.08 UNSPECIFIC ERROR 0;8 FREE TEXT
INPUT TRANSFORM:K:$L(X)>60!($L(X)<1) X
LAST EDITED: SEP 24, 2002
HELP-PROMPT: Answer must be 1-60 characters in length.
DESCRIPTION: This is the text to describe the error associated with EOB detail records when the ERROR CATEGORY
field is OTHER.
344.41,.09 TRANSFERRED OUT MSG # 0;9 FREE TEXT
INPUT TRANSFORM:K:$L(X)>20!($L(X)<1) X
LAST EDITED: OCT 24, 2002
HELP-PROMPT: Answer must be 1-20 characters in length.
DESCRIPTION: This field will hold the last mail message number used to transmit a detail record for an EOB
received for a bill belonging to another site.
344.41,.1 TRANSFER STATUS 0;10 SET
'0' FOR NOT ACCEPTED;
'1' FOR ACCEPTED;
LAST EDITED: OCT 24, 2002
HELP-PROMPT: Enter the code that corresponds to the status of the EOB transferred to another site
DESCRIPTION: This field indicates whether or not an EOB transfer has been accepted by a site to whom this EOB
detail record was sent.
344.41,.11 TRANSFERRED TO SITE 0;11 POINTER TO INSTITUTION FILE (#4)
LAST EDITED: OCT 25, 2002
HELP-PROMPT: Enter the name of the site where the EOB detail record will be sent
DESCRIPTION:
This is the name of the site where the EOB detail record will be sent.
344.41,.12 TRANSFERRED DATE 0;12 DATE
INPUT TRANSFORM:S %DT="ETX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: JAN 15, 2003
HELP-PROMPT: Enter the date the EOB was last transferred to another site
DESCRIPTION:
This is the latest date/time when the transfer of the EOB detail record took place.
CROSS-REFERENCE:344.4^ATOUT
1)= S ^RCY(344.4,"ATOUT",$E(X,1,30),DA(1),DA)=""
2)= K ^RCY(344.4,"ATOUT",$E(X,1,30),DA(1),DA)
3)= Do not delete
This cross reference allows easy access to EOBs that have been transferred out of the site to
another site.
344.41,.13 ERROR STATUS 0;13 SET
'0' FOR UNRESOLVED;
'1' FOR RESOLVED;
LAST EDITED: OCT 24, 2002
HELP-PROMPT: Enter the code to indicate if the error for this EOB detail record has been resolved.
DESCRIPTION: This indicates if the error associated with this EOB detail record was resolved or not. If
resolved, it will not appear on any more EOB detail exception lists.
RECORD INDEXES: AMCCF (#845)
344.41,.14 REVERSAL 0;14 SET
'0' FOR NO;
'1' FOR YES;
LAST EDITED: JAN 07, 2003
HELP-PROMPT: Enter a 1 (YES) if this is a reversal notification
DESCRIPTION:
This is the flag that indicates the bill was not paid, but was reversed.
CROSS-REFERENCE:344.41^ATB
1)= S ^RCY(344.4,DA(1),1,"ATB",$E(X,1,30),DA)=""
2)= K ^RCY(344.4,DA(1),1,"ATB",$E(X,1,30),DA)
3)= Do not delete
This xref is used to easily find reversal or takeback EOBs in an ERA.
344.41,.15 FREE TEXT PATIENT NAME 0;15 FREE TEXT
INPUT TRANSFORM:K:$L(X)>35!($L(X)<1) X
LAST EDITED: DEC 23, 2002
HELP-PROMPT: Answer must be 1-35 characters in length.
DESCRIPTION: This is the name of the patient as returned by the payer. Used only if the bill cannot be found at
the site.
344.41,.16 TRANSFER RECEIVED OTHER SITE 0;16 SET
'0' FOR NO;
'1' FOR YES;
LAST EDITED: JAN 15, 2003
HELP-PROMPT: Enter YES (1) if the other site has received the transferred EOB
DESCRIPTION:
This indicates whether or not the other site has received the transferred EOB record.
344.41,.17 BILL NUMBER FROM PAYER 0;17 FREE TEXT
INPUT TRANSFORM:K:$L(X)>15!($L(X)<1) X
LAST EDITED: APR 09, 2003
HELP-PROMPT: Answer must be 1-15 characters in length.
DESCRIPTION: If a bill number must be edited because it could not be found in the site's A/R file, this is the
original bill # that the payer sent.
WRITE AUTHORITY:^
NOTES: TRIGGERED by the INVALID BILL NUMBER field of the ERA DETAIL sub-field of the ELECTRONIC REMITTANCE
ADVICE File
344.41,.18 BILLING PROVIDER NPI 3;1 FREE TEXT
INPUT TRANSFORM:K:$L(X)>10!($L(X)<10)!'(X?10N) X
LAST EDITED: JUN 14, 2007
HELP-PROMPT: Answer must be 10 characters in length.
DESCRIPTION: This field contains the NPI for the Billing Provider that is found in piece 16 of the line type 10
of the 835ERA sent from Austin Information Technology Center.
344.41,.19 RENDERING/SERVICING PROV NPI 3;2 FREE TEXT
INPUT TRANSFORM:K:$L(X)>10!($L(X)<10)!'(X?10N) X
LAST EDITED: MAY 06, 2008
HELP-PROMPT: Answer must be 10 characters in length.
DESCRIPTION: This field contains the NPI for the Rendering/Servicing Provider that is found in piece 16 of the
line type 10 of the 835ERA sent from the Austin Information Technology Center. This field is named
Rendering NPI on the 835ERA and can contain the NPI for the Rendering (individual) or the Servicing
(non-individual) provider.
344.41,.2 ENTITY TYPE QUALIFIER 3;3 SET
'1' FOR INDIVIDUAL;
'2' FOR NON-INDIVIDUAL;
LAST EDITED: OCT 18, 2007
HELP-PROMPT: Enter a '1' for an individual NPI or a '2' for a non-individual NPI.
DESCRIPTION: This field reflects the type of NPI that is being returned in the NM1 segment of the X12N 835. If
it is a 1 then the NPI is for an individual provider. If it is a 2 then it is a non-individual
(organizational) NPI. This data is found in piece 17 of line type 10 in the 835ERA message
transmitted from the Austin Information Technology Center.
344.41,.21 RENDERING/SERVICING PROV NAME 3;4 FREE TEXT
INPUT TRANSFORM:K:$L(X)>96!($L(X)<2) X
LAST EDITED: JUN 21, 2010
HELP-PROMPT: Answer must be 2-96 characters in length.
DESCRIPTION: This field holds the value of the "Rendering Provider Name" field from the NM1 segment of the X12N
835. It is last name (or servicing organization name) concatenated with a comma (if there is a
first name) concatenated with the first name. The last name is piece 18 of a line type of 10 in
the 835ERA message and the first name is piece 19 of a line type of 10 in the 835ERA message
transmitted from the Austin Information Technology Center.
344.41,.22 BILLING PROV COMMENT 3;5 FREE TEXT
BILLING PROVIDER NPI REJECT COMMENT
INPUT TRANSFORM:K:$L(X)>80!($L(X)<3) X
LAST EDITED: APR 28, 2008
HELP-PROMPT: Answer must be 3-80 characters in length.
DESCRIPTION: This comment is about the Billing Provider NPI. This field is filled in only if the NPI is not in
proper format.
344.41,.23 REN PROV COMMENT 4;1 FREE TEXT
RENDERING/SERVICING PROVIDER NPI REJECT COMMENT
INPUT TRANSFORM:K:$L(X)>80!($L(X)<3) X
LAST EDITED: JUN 21, 2010
HELP-PROMPT: Answer must be 3-80 characters in length.
DESCRIPTION: This field is filled in with a comment if the Rendering/Servicing Provider NPI is not in correct
format.
344.41,.24 ECME # 4;2 FREE TEXT
ELECTRONIC CLAIMS MANAGEMENT ENGINE NUMBER
INPUT TRANSFORM:K:$L(X)>12!($L(X)<1) X
LAST EDITED: MAY 05, 2014
HELP-PROMPT: Answer must be 1-12 characters in length.
DESCRIPTION: The ELECTRONIC CLAIMS MANAGEMENT ENGINE NUMBER is used to track an ERA for matching, posting, and
reporting claims.
CROSS-REFERENCE:344.41^ECME
1)= S ^RCY(344.4,DA(1),1,"ECME",$E(X,1,30),DA)=""
2)= K ^RCY(344.4,DA(1),1,"ECME",$E(X,1,30),DA)
This cross-reference is for locating the ECME number(s) for an ERA.
344.41,.25 RECEIPT 4;3 POINTER TO AR BATCH PAYMENT FILE (#344)
LAST EDITED: JAN 10, 2015
HELP-PROMPT: Select the AR BATCH PAYMENT entry associated with this ERA DETAIL sub-file entry.
DESCRIPTION:
This is the AR BATCH PAYMENT entry that has the associated Receipt Number.
CROSS-REFERENCE:344.41^RECEIPT
1)= S ^RCY(344.4,DA(1),1,"RECEIPT",$E(X,1,30),DA)=""
2)= K ^RCY(344.4,DA(1),1,"RECEIPT",$E(X,1,30),DA)
CROSS-REFERENCE:344.4^H
1)= S ^RCY(344.4,"H",$E(X,1,30),DA(1),DA)=""
2)= K ^RCY(344.4,"H",$E(X,1,30),DA(1),DA)
This cross reference is for the RECEIPT that is stored at each of the individual claim lines within
an ERA.
RECORD INDEXES: AMCCF (#845)
344.41,1 RAW DATA 1;0 WORD-PROCESSING #344.411 (NOWRAP)
DESCRIPTION: This field stores the raw data as it was received for the individual EOB if its detail could not be
stored in IB.
LAST EDITED: SEP 24, 2002
HELP-PROMPT: Enter the raw data associated with this EOB record
DESCRIPTION: This is the raw data received in a message for an EOB record in error. It is saved here so the
data is not lost if needed for transfer to another station or for recovery of data unable to be
stored in IB.
344.41,1.1 FORMATTED MESSAGE DATA ; COMPUTED
MUMPS CODE: S X="" N Q,Q0,Q1 D DISP^RCDPESR0("^RCY(344.4,"_D0_",1,"_D1_",1)","Q0",1,"Q1",75,1) I $O(Q1(0)) D EN
^DDIOL("FORMATTED MESSAGE DATA: ","","!!") S Q=0 F S Q=$O(Q1(Q)) D:'Q EN^DDIOL(" ","","!") Q:'Q D
EN^DDIOL(Q1(Q),"","!")
ALGORITHM: S X="" N Q,Q0,Q1 D DISP^RCDPESR0("^RCY(344.4,"_D0_",1,"_D1_",1)","Q0",1,"Q1",75,1) I $O(Q1(0)) D EN
^DDIOL("FORMATTED MESSAGE DATA: ","","!!") S Q=0 F S Q=$O(Q1(Q)) D:'Q EN^DDIOL(" ","","!") Q:'Q D
EN^DDIOL(Q1(Q),"","!")
LAST EDITED: NOV 04, 2002
344.41,2 RESOLUTION LOG 2;0 WORD-PROCESSING #344.412 (NOWRAP)
DESCRIPTION: This field contains comments to detail the attempts made to remove the exception condition
associated with this individual EOB.
LAST EDITED: OCT 30, 2002
HELP-PROMPT: Enter a description of the attempts to resolve any exception
DESCRIPTION: This is the log used to keep track of the actions/results of any attempts to resolve the
exceptions associated with this EOB detail record.
344.41,4 CLAIM COMMENT 6;3 FREE TEXT
INPUT TRANSFORM:K:$L(X)>132!($L(X)<3) X
LAST EDITED: OCT 30, 2015
HELP-PROMPT: Answer must be 3-132 characters in length.
DESCRIPTION: This field will hold any claim comments used to indicate what was done to this line item to get
exceptions resolved so the claim will post and get the ERA processed.
344.41,4.01 CLAIM COMMENT DATE 6;2 DATE
INPUT TRANSFORM:S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: JAN 06, 2016
HELP-PROMPT: Enter date comment was added to this detail record.
DESCRIPTION:
This will be the date that this comment was added/updated. Date is required but time is optional.
344.41,4.02 CLAIM COMMENT USER 6;1 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: JAN 05, 2016
HELP-PROMPT: Enter the name of user that added/edited this comment.
DESCRIPTION:
This will be the pointer to the user that entered/updated this comment last.
344.41,5 AUTO-POST REJECTION REASON 5;1 SET
'1' FOR FIELD VERIFICATION FAILED;
'2' FOR CLAIM ALREADY COMPLETED/CLOSED;
'3' FOR PAYMENT EXCEEDS CLAIM BALANCE;
'4' FOR REFERRED TO GENERAL COUNCIL;
'5' FOR REJECTED (COMPLETED/CLOSED);
'6' FOR PAYMENT AMOUNT IS NEGATIVE;
'7' FOR REJECTED (GENERAL COUNCIL);
LAST EDITED: JUL 28, 2014
HELP-PROMPT: Enter the reason that auto-post rejected this line.
DESCRIPTION: This field describes the reason that caused the ERA detail line to be rejected by the ERA
auto-posting process in the AR nightly job.
344.41,6 MARK FOR AUTO-POST 5;2 SET
'0' FOR NO;
'1' FOR YES;
LAST EDITED: MAY 21, 2014
HELP-PROMPT: Enter YES if the EEOB line item in the ERA is marked for auto-posting.
DESCRIPTION: This flag identifies if the EEOB line item in the ERA is marked for automatic posting to a
receipt during the nightly job process.
CROSS-REFERENCE:344.4^AP
1)= S ^RCY(344.4,"AP",$E(X,1,30),DA(1),DA)=""
2)= K ^RCY(344.4,"AP",$E(X,1,30),DA(1),DA)
This cross reference is used to identify ERA claim lines which have been marked for auto-post in
the EDI Lockbox option 'Auto-Post Awaiting Resolution'.
344.41,6.01 MARKED FOR AUTOPOST USER 5;7 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: NOV 14, 2017
HELP-PROMPT: Select the person who marked the ERA detail for auto-posting
DESCRIPTION: This is the person who marked the ERA detail for auto-posting. This field is set automatically
by the system.
344.41,7 AUTO-DECREASE INDICATOR 5;3 SET
'1' FOR YES;
LAST EDITED: MAY 06, 2014
HELP-PROMPT: Enter Yes to indicate that the claim is auto-decreased.
DESCRIPTION: This field indicates that the claim on this ERA DETAIL line has been reviewed by the nightly
decrease adjustment process.
344.41,8 AUTO-DECREASE AMOUNT 5;4 NUMBER
INPUT TRANSFORM:S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>9999)!(X<0) X
LAST EDITED: MAY 06, 2014
HELP-PROMPT: Type a dollar amount between 0 and 9999, 2 decimal digits.
DESCRIPTION: This is the dollar amount of the decrease adjustment applied to the claim on this ERA DETAIL line
by the nightly automatic decrease adjustment process.
RECORD INDEXES: AMCCF (#845)
344.41,9 AUTO-POST DATE 5;5 DATE
INPUT TRANSFORM:S %DT="EX" D ^%DT S X=Y K:X<1 X
LAST EDITED: MAR 26, 2014
HELP-PROMPT: Enter the date on which this claim was auto-posted.
DESCRIPTION:
This is the date on which the claim line was auto-posted by the AR Nightly process.
CROSS-REFERENCE:344.4^F
1)= S ^RCY(344.4,"F",$E(X,1,30),DA(1),DA)=""
2)= K ^RCY(344.4,"F",$E(X,1,30),DA(1),DA)
This cross reference is for the auto-posting date of individual claim lines within an ERA.
RECORD INDEXES: AMCCF (#845)
344.41,9.01 PHARMACY CLAIM COMMENT 9;1 FREE TEXT
INPUT TRANSFORM:K:$L(X)>80!($L(X)<3) X
LAST EDITED: FEB 26, 2014
HELP-PROMPT: Answer must be 3-80 characters.
DESCRIPTION:
This field is informational and is to aid users in the processing of pharmacy claims.
344.41,9.02 MCCF DATE/TIME 9;2 DATE
INPUT TRANSFORM:S %DT="ESTR" D ^%DT S X=Y K:X<1 X
LAST EDITED: MAY 28, 2020
HELP-PROMPT: Enter the date/time the ERA detail line data changed
DESCRIPTION: This field is updated each time any ERA detail line field required for MCCF reporting is updated.
The field is used by MCCF extract RPCs to identify recently changed ERA detail line data.
TECHNICAL DESCR:
This field is updated by action cross reference AMCCF1.
CROSS-REFERENCE:344.41^MCCF
1)= S ^RCY(344.4,DA(1),1,"MCCF",$E(X,1,30),DA)=""
2)= K ^RCY(344.4,DA(1),1,"MCCF",$E(X,1,30),DA)
Recent ERA Changes Index for the MCCF Extract.
FIELD INDEX: AMCCF1 (#846) MUMPS IR ACTION
Short Descr: Updates List of ERA level changes for MCCF Extract
Description: When the MCCF DATE/TIME (#9.02) field in this subfile entry is updated, set the MCCF DATE/TIME
(#9) field of the superfile (ELECTRONIC REMITTANCE ADVICE (#344.4)) entry to NOW.
Set Logic: N FDA,MSG,DIERR S FDA(344.4,DA(1)_",",9)="NOW" D FILE^DIE("E","FDA","MSG") Q
Kill Logic: Q
X(1): MCCF DATE/TIME (344.41,9.02) (forwards)
NO RE-INDEXING ALLOWED!
344.41,10 AUTO-DECREASE DATE 5;6 DATE
INPUT TRANSFORM:S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: MAY 06, 2014
HELP-PROMPT: Enter the date on which this claim was auto-decreased.
DESCRIPTION:
This is the date on which the claim line was auto-decreased by the AR Nightly process.
CROSS-REFERENCE:344.4^G
1)= S ^RCY(344.4,"G",$E(X,1,30),DA(1),DA)=""
2)= K ^RCY(344.4,"G",$E(X,1,30),DA(1),DA)
This cross reference is for the auto-decrease date of individual claim lines within an ERA.
RECORD INDEXES: AMCCF (#845)
344.41,10.01 CHECKED FOR FIRST PARTY AD 5;8 SET
'1' FOR YES;
LAST EDITED: JUL 05, 2019
HELP-PROMPT: Enter 'YES' if this line was checked for 1st Party Auto-Decrease.
DESCRIPTION: This field is used in the PRCA NIGHTLY PROCESS to ensure that each ERA detail line is only
checked and processed once for first party auto-decrease. The field is set automatically by the
system.
344.41,99 BILL REFERENCE NUMBER ; COMPUTED
MUMPS CODE: S:'$G(DA(1)) DA(1)=+$G(D0),DA=+$G(D1) S X=$$GETBILL^RCDPESR0(.DA)
9.2 = S Y(344.41,99,81)=$G(D1),Y(344.41,99,80)=$G(D0),Y(344.41,99,1)=$S($D(^RCY(344.4,D0,1,D1,0)):^
(0),1:"")
9.3 = X ^DD(344.41,99,9.2) S D0=$P(Y(344.41,99,1),U,2) S:'D0!'$D(^IBM(361.1,+D0,0)) D0=-1 S Y(344.4
1,99,101)=$S($D(^IBM(361.1,D0,0)):^(0),1:"")
9.4 = X ^DD(344.41,99,9.3) S Y(344.41,99,102)=$G(X),D0=$P(Y(344.41,99,101),U,1) S:'D0!'$D(^DGCR(399
,+D0,0)) D0=-1 S Y(344.41,99,201)=$S($D(^DGCR(399,D0,0)):^(0),1:"")
9.5 = X ^DD(344.41,99,9.4) S D0=$P(Y(344.41,99,1),U,2) S:'D0!'$D(^IBM(361.1,+D0,0)) D0=-1 S Y(344.4
1,99,280)=$G(D0),Y(344.41,99,201)=$S($D(^IBM(361.1,D0,0)):^(0),1:"")
9.6 = X ^DD(344.41,99,9.5) S Y(344.41,99,202)=$G(X),D0=$P(Y(344.41,99,201),U,1) S:'D0!'$D(^DGCR(399
,+D0,0)) D0=-1 S Y(344.41,99,301)=$S($D(^DGCR(399,D0,0)):^(0),1:"")
ALGORITHM: S:'$G(DA(1)) DA(1)=+$G(D0),DA=+$G(D1) S X=$$GETBILL^RCDPESR0(.DA)
LAST EDITED: SEP 25, 2003
344.4,2 ERA LEVEL ADJUSTMENTS 2;0 Multiple #344.42 (Add New Entry without Asking)
DESCRIPTION: This field holds the ERA level adjustments the payer has applied to the ERA. These can be
additional monies or less monies, depending on the type of adjustment (i.e. Takeback would be
less money, interest would be more money).
INDEXED BY: REFERENCE NUMBER (B)
344.42,.01 REFERENCE NUMBER 0;1 FREE TEXT (Multiply asked)
INPUT TRANSFORM: K:$L(X)>50!($L(X)<1) X
LAST EDITED: JUN 22, 2010
HELP-PROMPT: Answer must be 1-50 characters in length.
FIELD INDEX: B (#982) REGULAR IR LOOKUP & SORTING
Short Descr: REGULAR INDEX
Set Logic: S ^RCY(344.4,DA(1),2,"B",$E(X,1,50),DA)=""
Kill Logic: K ^RCY(344.4,DA(1),2,"B",$E(X,1,50),DA)
Whole Kill: K ^RCY(344.4,DA(1),2,"B")
X(1): REFERENCE NUMBER (344.42,.01) (Subscr 1) (Len 50) (forwards)
344.42,.02 ADJUSTMENT CODE 0;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>5!($L(X)<1) X
LAST EDITED: DEC 23, 2002
HELP-PROMPT: Answer must be 1-5 characters in length.
DESCRIPTION:
This is the X12 code for the reason for the adjustment.
344.42,.03 ADJUSTMENT AMOUNT 0;3 NUMBER
INPUT TRANSFORM: S:X["$" X=$P(X,"$",2) K:X'?."-".N.1".".2N!(X>999999999999.99)!(X<-999999999999.99) X
LAST EDITED: DEC 23, 2002
HELP-PROMPT: Type a Dollar Amount between -999999999999.99 and 999999999999.99, 2 Decimal Digits
DESCRIPTION:
This is the amount of the adjustment.
344.42,.04 ADJUSTMENT TEXT 1;1 FREE TEXT
INPUT TRANSFORM: K:$L(X)>190!($L(X)<1) X
LAST EDITED: JUN 21, 2010
HELP-PROMPT: Answer must be 1-190 characters in length.
DESCRIPTION:
This is the text that describes the adjustment code.
344.4,3.01 CONTACT NAME 3;1 FREE TEXT
INPUT TRANSFORM: K:$L(X)>30!($L(X)<1) X
LAST EDITED: MAR 20, 2003
HELP-PROMPT: Answer must be 1-30 characters in length.
DESCRIPTION:
This is the name of the contact the payer has provided for questions regarding this ERA.
344.4,3.02 CONTACT NUMBER 1 3;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>60!($L(X)<1) X
LAST EDITED: AUG 02, 2010
HELP-PROMPT: Answer must be 1-60 characters in length.
DESCRIPTION:
This is a phone #/telephone extension or email address for the contact.
344.4,3.03 CONTACT TYPE 1 3;3 SET
'EM' FOR E-MAIL;
'FX' FOR FAX;
'TE' FOR TELEPHONE;
'EX' FOR TELEPHONE EXTENSION;
LAST EDITED: MAR 20, 2003
HELP-PROMPT: Enter the code for the type of contact information.
DESCRIPTION: This is the code that describes the type of contact information provided in the CONTACT NUMBER 1
field.
344.4,3.04 CONTACT NUMBER 2 3;4 FREE TEXT
INPUT TRANSFORM: K:$L(X)>60!($L(X)<1) X
LAST EDITED: AUG 02, 2010
HELP-PROMPT: Answer must be 1-60 characters in length.
DESCRIPTION:
This is a phone #/telephone extension or email address for the contact.
344.4,3.05 CONTACT TYPE 2 3;5 SET
'EM' FOR E-MAIL;
'FX' FOR FAX;
'TE' FOR TELEPHONE;
'EX' FOR TELEPHONE EXTENSION;
LAST EDITED: MAR 20, 2003
HELP-PROMPT: Enter the code for the type of contact information.
DESCRIPTION: This is the code that describes the type of contact information provided in the CONTACT NUMBER 2
field.
344.4,3.06 CONTACT NUMBER 3 3;6 FREE TEXT
INPUT TRANSFORM: K:$L(X)>60!($L(X)<1) X
LAST EDITED: AUG 02, 2010
HELP-PROMPT: Answer must be 1-60 characters in length.
DESCRIPTION:
This is a phone #/telephone extension or email address for the contact.
344.4,3.07 CONTACT TYPE 3 3;7 SET
'EM' FOR E-MAIL;
'FX' FOR FAX;
'TE' FOR TELEPHONE;
'EX' FOR TELEPHONE EXTENSION;
LAST EDITED: MAR 20, 2003
HELP-PROMPT: Enter the code for the type of contact information.
DESCRIPTION: This is the code that describes the type of contact information provided in the CONTACT NUMBER 3
field.
344.4,4.01 AUTO-POST DATE 4;1 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: JUN 06, 2014
HELP-PROMPT: Enter the date that this ERA was auto-posted.
DESCRIPTION: This date is set by the auto-posting process in the PRCA nightly job when a matching ERA is found
for an EFT which is accepted by FMS.
This only applies if the ERA has no adjustments or interest charges and no pharmacy claims.
344.4,4.02 AUTO-POST STATUS 4;2 SET
'0' FOR UNPOSTED;
'1' FOR PARTIAL;
'2' FOR COMPLETE;
LAST EDITED: MAR 26, 2014
HELP-PROMPT: Enter the status for the ERA.
DESCRIPTION: This field indicates if all the claim lines on an ERA have been posted as 'TR' receipts to Accounts
Receivable.
CROSS-REFERENCE: 344.4^E
1)= S ^RCY(344.4,"E",$E(X,1,30),DA)=""
2)= K ^RCY(344.4,"E",$E(X,1,30),DA)
This cross-reference is used to find ERA entries by the AUTO-POST STATUS for lookup and reporting
purposes.
344.4,4.03 LATEST AUTO-DECREASE DATE 4;4 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: MAY 06, 2014
HELP-PROMPT: Enter date that this ERA was last auto-decreased.
DESCRIPTION: This is the date that the ERA was last processed for automatic decrease adjustments by the nightly
process.
344.4,4.04 MARKED FOR AUTOPOST USER 4;3 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: DEC 11, 2017
HELP-PROMPT: Select the person who marked the ERA for auto-posting
DESCRIPTION: This is the person who marked the ERA for auto-posting. This field is set automatically by the
system.
344.4,5.01 PAYER WEB SITE ADDRESS 5;1 FREE TEXT
INPUT TRANSFORM: K:$L(X)>115!($L(X)<1) X
LAST EDITED: JUN 18, 2010
HELP-PROMPT: Enter payer web site address (1-115 characters).
DESCRIPTION: This is the web site for the payer. The source for this field is the contact data record (type
'01') of the X12 835 received from FSC.
TECHNICAL DESCR:
From 835 record 1000A PER04 where PER01 = "IC" and 1000A PER03 = "UR"
344.4,5.03 DATE CHECK MATCHED 5;3 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:X<1 X
LAST EDITED: JAN 12, 2022
HELP-PROMPT: (No range limit on date)
DESCRIPTION: Date the ERA was matched to a paper check if the EFT MATCH STATUS is 2 (MATCHED TO PAPER CHECK).
Date the ERA was matched to a TDA if the EFT MATCH STATUS is 5 (MATCHED TO A TDA).
TECHNICAL DESCR: This date will be automatically set to today's date by the software when an ERA is matched to a
paper check or to a TDA.
344.4,5.04 CHECK MATCHED USER 5;4 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: JAN 12, 2022
DESCRIPTION: The user who matched the ERA to a paper check if the EFT MATCH STATUS is 2 (MATCHED TO PAPER
CHECK). The user who matched the ERA to a TDA if the EFT MATCH STATUS is 5 (MATCHED TO A TDA).
TECHNICAL DESCR: This field will be automatically set to the current user by the software when an ERA is matched to
a paper check or to a TDA.
344.4,7.01 DATE/TIME ERA LINKED 7;1 DATE
INPUT TRANSFORM: S %DT="ESTXR" D ^%DT S X=Y K:X<1 X
LAST EDITED: MAR 24, 2011
HELP-PROMPT: Enter the date/time the ERA was linked to receipt.
DESCRIPTION:
This is date/time the ERA was linked to receipt.
CROSS-REFERENCE: 344.4^AFL
1)= S ^RCY(344.4,"AFL",$E(X,1,30),DA)=""
2)= K ^RCY(344.4,"AFL",$E(X,1,30),DA)
Created to find entries to include on ERA posted to Paper EOB report.
344.4,7.02 ERA LINKED BY 7;2 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: MAR 28, 2011
HELP-PROMPT: Select the person who linked the ERA to the receipt.
DESCRIPTION:
This is the person who linked the ERA to the receipt.
RECORD INDEXES: AMCCF (#828)
344.4,8 OTHER RECEIPT NUMBERS 8;0 POINTER Multiple #344.48
DESCRIPTION: An auto-posted ERA can have multiple receipt numbers. If there is more than one receipt number for
an ERA the subsequent receipt numbers are stored in this sub-file.
344.48,.01 OTHER RECEIPT NUMBER 0;1 POINTER TO AR BATCH PAYMENT FILE (#344) (Multiply asked)
LAST EDITED: FEB 25, 2014
HELP-PROMPT: Enter the subsequent receipt number assigned to EEOB line(s) after initial auto-post .
DESCRIPTION:
This is the receipt created to record the detail of the ERA for AR posting.
CROSS-REFERENCE: 344.48^B
1)= S ^RCY(344.4,DA(1),8,"B",$E(X,1,30),DA)=""
2)= K ^RCY(344.4,DA(1),8,"B",$E(X,1,30),DA)
344.4,9 MCCF DATE/TIME 9;1 DATE
INPUT TRANSFORM: S %DT="ESTR" D ^%DT S X=Y K:X<1 X
LAST EDITED: MAY 28, 2020
HELP-PROMPT: Enter the date/time the ERA data changed
DESCRIPTION: This field is updated each time any ERA field required for MCCF reporting is updated. The field is
used by MCCF extract RPCs to identify recently changed ERA data.
TECHNICAL DESCR:
This field is updated by action cross reference AMCCF.
CROSS-REFERENCE: 344.4^MCCF
1)= S ^RCY(344.4,"MCCF",$E(X,1,30),DA)=""
2)= K ^RCY(344.4,"MCCF",$E(X,1,30),DA)
Recent ERA Changes Index for the MCCF Extract.
344.4,20.01 DATE POSTED TO SUSPENSE 20;1 DATE
INPUT TRANSFORM: S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: MAY 15, 2003
HELP-PROMPT: Enter the date/time this receipt was posted to suspense.
DESCRIPTION:
This is the date/time this ERA was posted to suspense.
344.4,20.02 POSTED TO SUSPENSE BY 20;2 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: MAY 15, 2003
HELP-PROMPT: Enter the name of the person who posted this ERA to suspense.
DESCRIPTION:
This is the person who posted this ERA to suspense.
344.4,20.03 PAPER EOB ENTRY 20;3 SET
'0' FOR NO;
'1' FOR YES;
LAST EDITED: AUG 28, 2003
HELP-PROMPT: Enter a 1 (YES) if the ERA was posted using a paper EOB.
DESCRIPTION: This is a flag that indicates if the ERA was not referenced when its data was posted to A/R and FMS
because the data was posted using the paper EOB instead.
FILES POINTED TO FIELDS
AR BATCH PAYMENT (#344) RECEIPT (#.08)
ERA DETAIL:RECEIPT (#.25)
OTHER RECEIPT NUMBERS:OTHER RECEIPT NUMBER (#.01)
EDI LOCKBOX EOB WORKLIST
(#344.49) RECEIPT (#.08)
ELECTRONIC REMITTANCE ADVICE
(#344.4) ERA DETAIL:SEQUENCE # (#.01)
EXPLANATION OF BENEFITS (#361.1) ERA DETAIL:EOB DETAIL (#.02)
INSTITUTION (#4) ERA DETAIL:TRANSFERRED TO SITE (#.11)
INSURANCE COMPANY (#36) ERA DETAIL:INSURANCE COMPANY ON BILL (#.04)
NEW PERSON (#200) REMOVED BY (#.16)
MARKED FOR AUTOPOST USER (#4.04)
CHECK MATCHED USER (#5.04)
ERA LINKED BY (#7.02)
POSTED TO SUSPENSE BY (#20.02)
ERA DETAIL:CLAIM COMMENT USER (#4.02)
MARKED FOR AUTOPOST USER (#6.01)
File #344.4
Record Indexes:
AMCCF (#828) RECORD MUMPS IR ACTION
Short Descr: Updates Recent ERA Changes Index for MCCF Extract
Description: When any of the defined fields are updated, set the MCCF DATE/TIME (#9) field to NOW.
Set Logic: N FDA,MSG,DIERR S FDA(344.4,DA_",",9)="NOW" D FILE^DIE("E","FDA","MSG") Q
Kill Logic: Q
X(1): ENTRY (344.4,.01) (forwards)
X(2): TRACE NUMBER (344.4,.02) (forwards)
X(3): INSURANCE CO ID (344.4,.03) (forwards)
X(4): ERA DATE (344.4,.04) (forwards)
X(5): TOTAL AMOUNT PAID (344.4,.05) (forwards)
X(6): PAYMENT FROM (344.4,.06) (forwards)
X(7): FILE DATE/TIME (344.4,.07) (forwards)
X(8): RECEIPT (344.4,.08) (forwards)
X(9): EFT MATCH STATUS (344.4,.09) (forwards)
X(10): INDIVIDUAL EOB COUNT (344.4,.11) (forwards)
X(11): CHECK # (344.4,.13) (forwards)
X(12): ERA DETAIL POST STATUS (344.4,.14) (forwards)
X(13): REMOVED DATE (344.4,.17) (forwards)
X(14): ERA LINKED BY (344.4,7.02) (forwards)
NO RE-INDEXING ALLOWED!
APT (#1526) RECORD REGULAR IR SORTING ONLY
Short Descr: Index by payer name and TIN
Description: Index by payer name and payer ID. To be used when sorting reports by payer name first then payer ID.
Set Logic: S ^RCY(344.4,"APT",$E(X(1),1,60),$E(X(2),1,30),DA)=""
Kill Logic: K ^RCY(344.4,"APT",$E(X(1),1,60),$E(X(2),1,30),DA)
Whole Kill: K ^RCY(344.4,"APT")
X(1): PAYMENT FROM (344.4,.06) (Subscr 1) (Len 60) (forwards)
X(2): INSURANCE CO ID (344.4,.03) (Subscr 2) (Len 30) (forwards)
ATP (#1527) RECORD REGULAR IR SORTING ONLY
Short Descr: Index by payer TIN and payer name.
Description: Index by payer ID and payer name. To be used when sorting reports by payer ID first then payer name.
Set Logic: S ^RCY(344.4,"ATP",$E(X(1),1,30),$E(X(2),1,60),DA)=""
Kill Logic: K ^RCY(344.4,"ATP",$E(X(1),1,30),$E(X(2),1,60),DA)
Whole Kill: K ^RCY(344.4,"ATP")
X(1): INSURANCE CO ID (344.4,.03) (Subscr 1) (Len 30) (forwards)
X(2): PAYMENT FROM (344.4,.06) (Subscr 2) (Len 60) (forwards)
ATRID (#292) RECORD MUMPS IR SORTING ONLY
Short Descr: Xref by bank trace # and ins co id #
Set Logic: S ^RCY(344.4,"ATRID",$E(X(1),1,50),$E(X(2),1,30),DA)=""
Kill Logic: K ^RCY(344.4,"ATRID",$E(X(1),1,50),$E(X(2),1,30),DA)
Whole Kill: K ^RCY(344.4,"ATRID")
X(1): TRACE NUMBER (344.4,.02) (Subscr 1) (Len 30) (forwards)
X(2): INSURANCE CO ID (344.4,.03) (Subscr 2) (Len 30) (forwards)
ATRIDUP (#403) RECORD MUMPS IR SORTING ONLY
Short Descr: Case-insensitive lookup for Trace # and Insurance Co.
Description: This cross-reference is used for claim matching without regard to case. The trace number and insurance company
are converted to uppercase and the software uses this for matching claims by the trace number. The values in
the TRACE NUMBER (#.02) and INSURANCE CO ID (#.03) fields remain unchanged.
Set Logic: S ^RCY(344.4,"ATRIDUP",$$UP^XLFSTR($E(X(1),1,50)),$$UP^XLFSTR($E(X(2),1,30)),DA)=""
Kill Logic: K ^RCY(344.4,"ATRIDUP",$$UP^XLFSTR($E(X(1),1,50)),$$UP^XLFSTR($E(X(2),1,30)),DA)
Whole Kill: K ^RCY(344.4,"ATRIDUP")
X(1): TRACE NUMBER (344.4,.02) (Subscr 1) (Len 50) (forwards)
X(2): INSURANCE CO ID (344.4,.03) (Subscr 2) (Len 30) (forwards)
Subfile #344.41
Record Indexes:
AMCCF (#845) RECORD MUMPS IR ACTION
Short Descr: Updates Recent ERA Changes Index for MCCF Extract
Description: When any of the defined fields are updated, set the MCCF DATE/TIME (#9.02) field in this subfile entry to NOW.
Set Logic: N FDA,MSG,DIERR S FDA(344.41,DA_","_DA(1)_",",9.02)="NOW" D FILE^DIE("E","FDA","MSG") Q
Kill Logic: Q
X(1): SEQUENCE # (344.41,.01) (forwards)
X(2): EOB DETAIL (344.41,.02) (forwards)
X(3): AMOUNT PAID (344.41,.03) (forwards)
X(4): RECEIPT (344.41,.25) (forwards)
X(5): ERROR STATUS (344.41,.13) (forwards)
X(6): AUTO-DECREASE AMOUNT (344.41,8) (forwards)
X(7): AUTO-POST DATE (344.41,9) (forwards)
X(8): AUTO-DECREASE DATE (344.41,10) (forwards)
NO RE-INDEXING ALLOWED!
AVAL (#293) RECORD MUMPS IR SORTING ONLY
Short Descr: Xref to find EOBs for bills not valid in VistA
Description: This cross reference is set when the free text bill number is entered for the EOB detail and when the EOB
detail pointer is deleted. This cross reference makes it possible to find those bills that do not belong to
the site, but were included in the ERA received from an insurance co.
Set Logic: S ^RCY(344.4,DA(1),1,"AVAL",DA)=""
Set Cond: S X=$S(X2(1)="":1,1:0)
Kill Logic: K ^RCY(344.4,DA(1),1,"AVAL",DA)
Kill Cond: S X=$S(X2(1)'="":1,1:0)
Whole Kill: K ^RCY(344.4,DA(1),1,"AVAL")
X(1): EOB DETAIL (344.41,.02) (forwards)
X(2): INVALID BILL NUMBER (344.41,.05) (forwards)
INPUT TEMPLATE(S):
PRINT TEMPLATE(S):
SORT TEMPLATE(S):
FORM(S)/BLOCK(S):