Loading...
Loading...
The report includes the following details.
| Column | Description | Data Populates From |
|---|---|---|
| Hide | Delete indicator | Hide check box. Displays Y or blank. |
| Loc Name | Name of the location | Location Name field on the Location Defaults tab.
|
| Addr 1 | Address 1 | Address (line 1) field on the Location Defaults tab.
|
| Addr 2 | Address 2 | Address (line 2) field on the Location Defaults tab
|
| City, State Zip | City, state ZIP | City, State, and Zip fields on the Location Defaults tab. |
| Country | Country | Country field on the Location Defaults tab. |
| County | County | County field on the Location Defaultstab. |
| Phone | Phone | Phone field on the Location Defaultstab. |
| Care Fac ID | Medicare facility ID | Medicare Facility ID field on the Claim Type sub tab on the Defaults 2tab. |
| BC/BS Fac ID | BCBS facility ID | BCBS Facility ID field on the Claim Type sub tab on the Defaults 2tab. |
| Caid Fac ID | Medicaid facility ID | Medicaid Facility ID field on the Claim Type sub tab on the Defaults 2tab. |
| Hcfa | HCFA Box 32 | HCFA Box 32 check box on the Claim Type sub-tab on the Defaults 2 tab. |
| Alt Phone Desc | Alternate phone description | Alt Phone Desc field on the Location Defaults tab. |
| Alt Phone | Alternate Phone | Alt Phone field on the Location Defaults tab. |
| Clia | CLIA | CLIA ID field on the Defaults2 tab. |
| Contact | Name of the contact | Contact Last Name, First Name, and MIfields on the Location Defaults tab. |
| Area Code | Area code | Dial Area Code on the Location Defaults tab. |
| DME Provider Nbr | DME Provider Number | DME Provider Nbr field on the Defaults2 tab. |
| Ext ID | External ID | External ID field on the Location Defaults tab. |
| Fac Ent ID | Facility entity ID | Facility Entity ID field on the Defaults2 tab. |
| Fax | Fax number | Fax field on the Location Defaults tab. |
| Fax Extras | Fax Extras | Fax Extras field on the Location Defaults tab. |
| Internal Loc | Internal location | Internal Location on the Location Defaults tab. |
| Subgrouping 1 | Location subgroup 1 | Location Subgrouping 1 field on the Location Defaults tab. |
| Subgrouping 2 | Location subgroup 2 | Location Subgrouping 2 field on the Location Defaults tab. |
| Loc Type | Location type | Location Designation field on the Location Defaults tab. |
| Mammo Cert Nbr | Mammography Certification Number | Mammo Certification field on the Defaults 2 tab. |
| Site ID | Site ID | Site ID Number field on the Defaults 2 tab. |
| Patient SIM Exception | Patient SIM Exception | Patient SIM Exception field on the Location Defaults tab. |
| Note | Notes | Notes field on the Location Defaults tab. |
| UB Grace Period | UB Grace Period | UB Grace Days field on the Defaults2 tab. |
| Prac Loc Addr 1 | Practice location address 1 | Address (line 1) field in the Statement Remit To section on the Practice tab. |
| Prac Loc Addr 2 | Practice location address 2 | Address (line 2) field in the Statement Remit To section on the Practice tab. |
| Prac Loc City, State Zip | Practice location city, state ZIP | City, State, and Zip fields in the Statement Remit To section on the Practice tab. . |
| Prac Loc Country | Practice location country | Country field in the Statement Remit To section on the Practice tab. |
| Prac Loc County | Practice location county | County field in the Statement Remit To section on the Practice tab. |
| Prac Loc Mammo Cert Nbr | Practice location mammography certification number | Mammo Certification field in the Claims Informationsection on the Practice tab. |
| Prac Loc Clia | Practice location CLIA | CLIA ID field in the Claims Information section on the Practice tab. |
| Prac Loc UB Grace Period | Practice location UB Grace Period | UB Grace Days field in the Claims Information section on the Practice tab. |
| Prac Loc DME Provider Nbr | Practice location DME provider number | DME Provider Nbr field in the Claims Information section on the Practice tab. |
| Prac Loc BC/BS Fac ID | Practice location BCBS facility ID | BCBS Facility ID field in the Claims Information section on the Practice tab. |
| Prac Loc Hcfa | Practice location HCFA | HCFA Box 32 check box in the Claims Information section on the Practice tab. |
| Prac Loc Caid Fac ID | Practice location medicaid facility ID | Medicaid Facility ID field in the Claims Information section on the Practice tab. |
| Prac Loc Care Fac ID | Practice location medicare facility ID | Medicare Facility ID field in the Claims Information section on the Practice tab. |
| Prac Loc Fac Loc | Practice location facility location | Facility Location check box in the Claims Information section on the Practice tab. |
| National Provider ID | National Provider ID | National Provider ID field on the Defaults 2 tab. |
| POS | Place of service | Place of Service field on the Location Defaults tab. |
| Loc Tax ID | Location tax ID | Location Tax ID field on the Defaults 2 tab. |
| DME NPI | DME National Provider ID | DME NPI field on the Defaults 2 tab. |
| Prac Clm DME NPI | Practice Claims DME National Provider ID | DME NPI field in the Claims Information section on the Practice tab. |
| Taxonomy | Taxonomy | Taxonomy Code field on the Defaults 2 tab. |
| Sched | Display in scheduling | Display in Scheduling check box on the Location Defaults tab. |
| Fac | Facility location | Facility Location on the Location Defaults tab. |
| Credent Type | Credentialing type | Credentialing Type field on the Credentialing tab. |
| Eff Dt | Credentialing effective date | Effective Date field on the Credentialing tab. |
| Exp Dt | Credentialing expiration date | Expiration Date field on the Credentialing tab. |
| Credent Num | Credentialing number | Number field on the Credentialing tab. |
| Credent Notes | Credentialing notes | Notes field on the Credentialing tab. |
| Enable CrossWalk in Charge Entry | Enable crosswalk in charge entry | Enable Crosswalk in Charge Entry check box on the Defaults 2 tab.
|
| CrossWalk Order | Crosswalk order | Crosswalk Order fieldon the Defaults 2 tab.
|
| Req Surgical Code at Charge Entry | Require surgical code at charge entry | Require Surgical Code at Charge Entry check box on the Defaults 2 tab.
|
| CCBHC Location | CCBHC location | CCBHC Location check box on the Defaults 2 tab. Displays Y or blank. |