CLP Claim Level Data
To supply information common to all services of a claim
Position
Element
Name
Type
Requirement
Min
Max
Repeat
Identifier used to track a claim from creation by the health care provider through payment
Code identifying the status of an entire claim as assigned by the payor, claim review organization or repricing organization
Monetary amount
CLP03 is the amount of submitted charges this claim.
Monetary amount
CLP04 is the amount paid this claim.
Monetary amount
CLP05 is the patient responsibility amount.
Code identifying type of claim
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
CLP07 is the payer's internal control number.
Code identifying the type of facility where services were performed; the first and second positions of the Uniform Bill Type code or the Place of Service code from the Electronic Media Claims National Standard Format
Code specifying the frequency of the claim; this is the third position of the Uniform Billing Claim Form Bill Type
Code indicating patient status as of the "statement covers through date"
Code indicating a patient's diagnosis group based on a patient's illness, diseases, and medical problems
Numeric value of quantity
CLP12 is the diagnosis-related group (DRG) weight.
Percentage expressed as a decimal (e.g., 0.0 through 1.0 represents 0% through 100%)
CLP13 is the discharge fraction.
Code indicating a Yes or No condition or response
CLP14 is the patient authorization to coordinate benefits. A "Y" indicates that the authorization exists; an "N" indicates that the authorization does not exist.