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835 Transmission Page Map | ||
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Fields that Display by Default | ||
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Field on Transmission Page |
Location of Data in EDI (documents imported after installation of TI 2.3.1) |
Location of Data in EDI (documents imported before installation of TI 2.3.1) |
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Amount |
BPR02 - Monetary Amount |
CLP03 - Monetary Amount |
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Assigned |
From My Tasks page |
From My Tasks page |
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Document Date |
GS04 - Date + GS05 - Time |
GS04 - Date + GS05 - Time |
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Number of Errors |
Count of errors with a severity greater than 2 |
Count of errors with a severity greater than 2 |
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Original File Date |
Date supplied by the -m Instream command line parameter |
Date supplied by the -m Instream command line parameter |
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Original File Name |
Name supplied by the -m Instream command line parameter |
Name supplied by the -m Instream command line parameter |
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Receiver |
Criteria set up by TI administrator |
Criteria set up by TI administrator |
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Sender |
Criteria set up by TI administrator |
Criteria set up by TI administrator |
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Status |
From My Tasks page |
From My Tasks page |
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Submitter Identifier |
ST level REF02 – Receiver Identification (optional segment – if value does not exist, NONE will display) |
CLP01 - Claim Submitter's Identifier |
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Fields that you can add with Choose Fields Link | ||
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Field on Transmission Page |
Location of Data in EDI (documents imported after installation of TI 2.3.1) |
Location of Data in EDI (documents imported before installation of TI 2.3.1) |
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Charge Amount |
Not mapped – will display as null if the document was imported by TI 2.3.1 or later. |
2100 - CLP03 |
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Check Number |
TRN02 |
TRN02 |
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Claim Number |
REF02 – Receiver Identification (optional segment) |
2100 - CLP07 |
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Amount835 |
BPR02 |
BPR02 |
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Error Type |
Do not use with new imports. |
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Insured Name ID Code |
2100 - NM109 where NM101 = IL |
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Issue Date |
BPR16 |
BPR16 |
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Paid Amount |
Not mapped – will display as null. |
2100 - CLP04 |
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Payee Additional Identifier |
1000B - REF02 |
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Payee Additional Identifier Qualifier |
1000B - REF01 |
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Payee Name |
1000B - N102 |
1000B - N102 |
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Payee Qualifier |
Not mapped – will display as null. |
Not mapped – will display as null. |
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Payee Tax ID |
1000B - N104 |
1000B - N104 |
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Payment Date |
BPR16 |
BPR16 |
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Receiver Identifier |
REF02 – Receiver Identification (optional segment) |
1000B - REF02 |
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Responsibility Amount |
Not mapped – will display as null. |
2100 - CLP05 |
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Service Provider ID Code |
2100 - NM109 where NM101 = 82 |
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