Eligibility Referral Report Columns
The following columns are available on the Eligibility Referral report:
| Column Name | Description | Data Populates From |
|---|---|---|
| Prac Name | Practice Name | Practice master file |
| Pat Name | Patient Full Name | Patient Maintenance |
| Per Nbr | Person Number | Patient Information |
| Insured | Name of Insured | Guarantor Maintenance |
| Insured Pat Nbr | Patient's HIC/Policy Number | Insurance Maintenance |
| Rendering | Rendering Provider (Requesting Physician) | Requesting physician from Inquiry |
| Referred To | Referral Rendering | Referred To field on the referral inquiry |
| Provider Subgrouping 1 | Provider Subgrouping 1 | Systems tab on the Provider Master (adds data to the list from the Requesting Physician field on the Inquiry) |
| Provider Subgrouping 2 | Provider Subgrouping 2 | Systems tab on the Provider Master (adds data to the list from the Requesting field on the Inquiry) |
| Payer Name | Payer Name associated with transaction | Insurance Maintenance associated with the transaction |
| Payer Subgrouping 1 | Payer Subgrouping 1 | Payer Defaults 2 tab on the Payer master (adds data to the list from the Patient Insurances field on the inquiry) |
| Payer Subgrouping 2 | Payer Subgrouping 2 | Payer Defaults 2 tab on the Payer master (adds data to the list from the Patient Insurances field on the inquiry) |
| Contracted Ind | Contracted Indicator | Payer master file |
| Inq Type | Type of Inquiry (Eligibility, New Referral, or Referral History) | Type of inquiry selected from the pop-up menu used to access an inquiry |
| SubmitStatus | Status of Inquiry | System-generated based on results of the transaction |
| Response Status | Response Status | Received from clearinghouse |
| Rejection Definition | Rejection Definition | Received from clearinghouse |
| Certification Type | Certification Type | Received from clearinghouse |
| Related Causes | Related Causes | Received from clearinghouse |
| Release Of Info | Release of Information | Received from clearinghouse |
| Quantity Qualifier | Quantity Qualifier | Received from clearinghouse |
| Quantity | Quantity | Received from clearinghouse |
| Note | Note | Inquiry |
| Patient Relationship | Patient Relationship | Patient chart |
| Number of Encs | Number of Encounters | New Referral Inquiry |
| Accident Date | Accident Date | Received from clearinghouse |
| (Client Defined 1-10) | Client-defined fields set up in Enterprise Preferences - Client Defined tab | Add/Modify Patient Information - Client Defined tab |
| Crt Dt | Create Date | System-generated based on the submission date of the inquiry |
| Appt Dt | Appointment Date | Appointment Book |
| Enc Nbr | Encounter Number | Encounter Maintenance |
| Created By | Created By | System-generated based on the User ID of the user who generated the inquiry |
| Mod Dt | Date inquiry was last modified | System-generated based on the submission date of the inquiry |
| Modified By | Name of the person who last modified the inquiry | System-generated based on the user ID |
| Loc Name | Location Name | Locations master file |
| Fac Cd | Facility Code | Attached encounter or encounter for the request. |
Filter 1
- Create Date: Include inquiries submitted within a date range.
- Statuses: Include inquiries by status. Select from Incomplete, Pending, Submit Error, Successful, and Loading Error.
- Inquiry Type: Include/exclude inquiries by type. Select from Eligibility, New Referral, Referral History, and Claims Status.
- Response Status: Include inquiries by response status. Select from Active, Inactive, and Mixed.
Filter 2
Use columns to filter data on the report. Column filter options include the following:
- Between
- Equals
- Not Equals
- Greater Than
- Less Than
- Like
Additional Filters
Use additional filters to filter data on the report. Additional filters include the following:
- Locations
- Provider Subgrouping 1 and 2
- Location Subgrouping 1 and 2
- Practices
- Primary Payers
- Rendering Physicians
- Specialty
Sorting
Use columns to sort and group data on the report. Column sorting options include the following:
- Ascending
- Descending
- Group By
- Page Break
Totals
Use columns to sub-total and total data on the report. Column total options include the following:
- Sum
- Average
- Count
- Totals