export_claim_submission_history
export_claim_submission_history
Claim submission history: one row per claim submission, distinguishing automated Candid submissions, Medicare crossovers, and external submissions, to insurance payers or non-insurance payers, with the essential clearinghouse and payer acknowledgement signals.
Primary Key: claim_submission_id
Identifiers
Unique ID associated with the claim submission in the Candid system
Unique Claim ID
Unique ID associated with the encounter in the Candid system
Organization
User’s unique organization ID in the Candid system
Organization Name
Timestamps
Time when the claim submission was created (i.e. when the claim was submitted)
Time when the claim submission or any of its related records (claim, payer, or acknowledgements) was last updated. Use this for incremental ingestion.
Time when the submission status last changed
Submission
Status of the submission: PASS, FAIL, or AWAITING_RESPONSE
How the claim was submitted: ‘Candid Automated’ (generated and transmitted by Candid), ‘External’ (submitted outside Candid and marked as externally submitted), or ‘Medicare Crossover’ (automatically forwarded by Medicare to a secondary payer)
True when Candid generated and transmitted the submission
True when the claim was submitted outside Candid and marked as externally submitted
True when the submission was automatically forwarded by Medicare to a secondary payer
Unique ID of the user who submitted the claim, when applicable (null for automated submissions)
Name of the user who submitted the claim, when applicable (null for automated submissions)
Identifier of the pipeline that submitted the claim, when applicable
The medium the claim was submitted on: electronic or paper
The clearinghouse or destination the claim was submitted to (e.g. Availity, Change Healthcare, Waystar)
The payer responsibility level for this submission: primary, secondary, or tertiary
Payer
Whether the submission was sent to an ‘Insurance’ payer or a ‘Non-Insurance Payer’
Unique ID of the insurance payer the claim was submitted to, when applicable
Name of the insurance payer the claim was submitted to, when applicable
Unique ID of the non-insurance payer the claim was submitted to, when applicable
Name of the non-insurance payer the claim was submitted to, when applicable
Submission Type & History
Claim frequency (type of bill) code: 1 = original, 7 = corrected/replacement, 8 = void
Derived submission type: Original, Resubmission, Corrected/Replacement, or Void
Ordinal position of this submission within the claim’s submission history (1 = first)
True for the earliest submission of the claim
True for the most recent submission of the claim
Acknowledgements
True when a 999 implementation acknowledgement has been received for this submission
The 999 transaction set acknowledgement code (e.g. A = accepted, R/E = rejected)
Time the latest 999 implementation acknowledgement was received, when available
True when a clearinghouse 277 acknowledgement has been received for this submission
The clearinghouse-assigned trace number from the clearinghouse 277 acknowledgement, when available
Time the latest clearinghouse 277 acknowledgement was received, when available
True when a payer 277 claim acknowledgement has been received for this submission
Health care claim status category code from the latest payer 277 acknowledgement
Health care claim status code from the latest payer 277 acknowledgement
The payer-assigned claim control number (ICN) from the payer 277 acknowledgement, when available
Time the latest payer 277 claim acknowledgement was received, when available
Computed acknowledgement stage classification: which gate (999 / clearinghouse 277 / payer 277) the submission last cleared or failed at, or ‘Healthy’
Additional Context
Payer-generated control number associated with the submission, when available
Reason provided when a force submission was used, when applicable