export_informational_adjustment_details | Candid

Additional information related to non-balance-impacting adjustments made to a claim. Enables comprehensive denial analysis by tracing denials back to their original ERAs and charges.

Primary Key: adjustment_detail_id

Identifiers

adjustment_detail_id

STRINGRequired

Line-item details behind a payer adjustment (the rationale behind a specific claim adjustment / remark code). This is captured in the ‘i’ bubble on the service line in Candid

adjustment_id

STRING

The Transaction ID for an adjustment

patient_id

STRING

Patient ID within Candid

encounter_id

STRING

Unique ID associated with the encounter in the Candid system

service_line_id

STRING

Unique ID associated with the service line in the Candid system

charge_id

STRING

Parent charge for the transaction, so it allows you to tie payments and adjustments to the original charge (billed A/R)

Timestamps

adjustment_timestamp

TIMESTAMP

Time when the ERA-derived adjustment itself was created

adjustment_updated_at

TIMESTAMP

Time when the ERA-derived adjustment itself was updated

table_record_updated_at

TIMESTAMP

Timestamp of the most recently updated source record contributing to this row. Used to detect newly ingested or updated records for incremental processing.

Organization

organization_id

STRING

Organization’s unique ID in the Candid system

organization_name

STRING

Organization Name

external_organization_id

STRING

Organization’s External ID - the ID that the organization uses to map to their own upstream system

Informational Adjustment Details

adjustment_type

STRING

Level of granularity of adjustment (provider, claim, or service line level). This can allow us to trace denials or adjustments made at a provider level, for example

amount_cents

INTEGER

Amount Cents

Adjustment Reason Codes

carc

STRING

Claim Adjustment Reason Code

claim_adjustment_group_code

STRING

The two-letter code that tells you who is responsible for the unpaid portion of a medical claim

adjustment_reason_code

STRING

Numerical code that tells you the reason for the adjustment

remark_codes

ARRAY<STRING>

Additional, non-financial information about the processing of a claim to supplement or clarify the reason for a payment adjustment that is already identified by a Claim Adjustment Reason Code (CARC)

payer_plan_group_id

STRING

Unique ID associated with the specific Payer Plan

Derived Details

external_payment_id

STRING

External Payment ID / Check Number

posted_status

STRING

Whether ERA was posted to Candid

check_date

DATE

Check Date

payment_posted_date

TIMESTAMP

Date of when Payment was posted in Candid

deposit_date

DATE

Date the associated payment was deposited

era_payer_name

STRING

Payer of the 835 file / organization that issued the remit

era_payer_identifier

STRING

The 2U segment code that is used to help specifically identify the insurance company that is underwriting what the payment is

claim_status_code

INTEGER

X12 claim status code from the ERA (835) indicating the overall adjudication status of the claim (e.g., processed as primary, denied)

payer_claim_control_number

STRING

The payer’s internal reference number for the claim, as reported in the ERA

created_by

STRING

User ID of the person who posted the adjustment

created_by_name

STRING

Name of the person who posted the adjustment

era_posted_by

STRING

User ID of the person who posted the ERA

era_posted_by_name

STRING

Name of the person who posted the ERA