EOD Posting File Lockbox G

Lockbox Version G of the EOD Posting File is 835 v1.0  and works with all grouping methods.  However, it needs to use different <Configurable Value> with Group by Merchant, or the groups will overwrite files because of the naming convention.

File Name Standard: <Database/File Grouping> + “_” + <Configurable Value> + “_” + BusinessDate + “.835”

Note: This version includes custom grouping and negative values in the CLP03, CLP04, BPR02 on refunds, also uses 4010 format 835.

Custom Grouping is:
First Two Letters of Patient Account NumberDatabase/File Grouping
HKBAR.AHH
FVBAR.FVH
HNBAR.HCH
HHBAR.HMH
PL|PP|RCBAR.LMCK
DR|FL|GH|HD|HF|MA|MK|SSBAR.MCK
NM|RMBAR.MCKORL
MRBAR.MRM
OCBAR.OCH
PIBAR.PCM
SXBAR.SCH
SHBAR.SHH
SL|RL|XL|PB|BBAR.SLH
QPBAR.QOP
GT|SYBAR.PIR
OtherDefault
SEGField IDField NameFormatRequired?Config?Expected ValueComments
BPRFinancial Information
BPR01Transaction Handling CodeANYY"H"
BPR02Payment AmountDECYAmountConfigurable via Support Tool. Can be "H," "C," "D," "I," "P". Amount can be positive or negative value dependent on sale/refund.
BPR03Credit/Debit Flag CodeANY"C" or "D"Payment Transaction action - sale = C; refund = D.
BPR04Payment Method CodeANYY"NON"Configurable via Support Tool. Can be: "NON," "FWT," "CHK," "BOP," "ACH".
BPR05Payment Format CodeSNot currently used.
BPR06(DFI) ID Number QualifierSNot currently used.
BPR07(DFI) Identification NumberSNot currently used.
BPR08Account Number QualifierSNot currently used.
BPR09Account NumberSNot currently used.
BPR10Originating Company IdentifierANSY"1999999999"Same as TRN 03.
BPR11Originating Company Supplemental CodeANSY"credit card," "eCheck," "cash," "manual check"Same as TRN 04. Transaction Type: Credit Card, eCheck, cash, manual check.
BPR12Depository Financial InstitutionSNot currently used.
BPR13Provider Bank ID NumberSNot currently used.
BPR14Account Number QualifierSNot currently used.
BPR15Provider Account NumberYNot currently used.
BPR16Check Issue or EFT Effective DateDTSBusiness Date
TRNReassociation Trace Number
TRN01Trace Type CodeANY"1"
TRN02Check or EFT Trace NumberANYYAuthorization NumberConfigurable via Support Tool. Maximum 30 characters in length.
TRN03Originating Company IdentifierANYY"1999999999"Configurable via Support Tool. Maximum of 9 characters + "1" appended at the beginning.
TRN04Originating Company Supplemental CodeANSY"credit card," "eCheck," "cash," "manual check"Configurable via Support Tool. Maximum Length 30 characters. Defaults to Transaction Type. Transaction Type: Credit Card, eCheck, cash, manual check .
N1Payer Identification
N101Entity Identifier CodeANY"PR"
N102NameANYPatient First Name + Patient Last NameIf not available, use "Patient," max 60 characters.
N103Identification Code QualifierANY"XV"
N104Payer IdentifierANYYPatient Account NumberConfigurable via Support Tool. Maximum value of 30. Defaults to "9999".
N3Payer Address
N301Payer Address LineANYYPatient Address 1Configurable via Support Tool Maximum Length of 55 characters.
N302Payer Address LineANSYPatient Address 2 if availableField ID is not used.
N4Payer City, State, ZIP Code
N401Payer City NameANYYPatient CityConfigurable via Support Tool - 30 characters max length; defaults to "City".
N402State or Province CodeANYYPatient StateConfigurable via Support Tool - 2 characters max length. Defaults to "CA".
N403Payer Postal ZoneANYYPatient Zip CodeConfigurable via Support Tool - 15 characters max, defaults to "99999".
N1Payee Identification
N101Entity Identifier CodeANY"PE"
N102Payee NameANSMerchant NamePatient Name (First + Middle + Last) defaults to "Patient" if not present.
N103Identification Code QualifierANY"FI"
N104Payee Identification CodeANYMerchant IDThe unique ID associated with your merchant processing account, which will be given by your Implementations Manager.
REFPayee Additional Identification
REF01Reference Identification QualifierANY"PQ"
REF02Additional Payee IdentifierANYMerchant|Store|Terminal IDThe unique ID associated with your merchant processing account, which will be given by your Implementations Manager.
CLPClaim Payment Information
CLP01Claim Submitter's IdentifierANYYPatient Account NumberConfigurable via Support Tool. Max length 38 characters. If not available, use "9999".
CLP02Claim Status CodeANY"0" OR "1" OR "22"Sale = 1; Refund = 22; Default = 0.
CLP03Total Claim Charge AmountDECYAmountNegative or positive based on refund or sale, respectively.
CLP04Claim Payment AmountDECYAmountNegative or positive based on refund or sale, respectively.
CLP05Patient Responsibility AmountDECS"0"
CLP06Claim Filing Indicator CodeANYY"13"Configurable via Support Tool Can be, "12," "13," "14," "15," "16," "AM," "CH," "DS," "HM," "LM," "MA," "MB," "MC," "OF," "TV," "VA," "WC".
CLP07Payer Claim Control NumberANSYTransaction IDConfigurable via Support Tool Max Length 30 characters.
CLP08Facility Code ValueSNot currently used.
CLP09Claim Frequency CodeSNot currently used.
CLP10Patient Status CodeSNot currently used.
CLP11Diagnosis Related Group (DRG) CodeSNot currently used.
CLP12Diagnosis Related Group (DRG) WeightSNot currently used.
CLP13Discharge FractionSNot currently used.
NM1Patient Name
NM101Entity Identifier CodeANY"QC"
NM102Entity Type QualifierANY"1"
NM103Patient Last NameANYPatient Last NameIf not available, use "Patient Last".
NM104Patient First NameANSPatient First NameIf not available, use "Patient First".
NM105Patient Middle NameANSPatient Middle NameNot currently used. If not available, use "Patient Middle".
NM106Name PrefixSNot currently used.
NM107Name SuffixSNot currently used.
NM108Identification Code QualifierANY"MI"
NM109Patient IdentifierANYYPatient Account NumberConfigurable via Support Tool. Maximum length of 80 characters Defaults to "9999".
REFOther Claim Related Identification
REF01QualifierANY"BB" OR "EA"Not currently used. BB = Auth Code; EA = Med Rec#.
REF02IdentifierANYAuthorization Number/Medical Record #Not currently used.
DTMClaim Date
DTM01QualifierANY232/233 to convey service start and end dateNot currently used. If not available, use transaction date.
DTM02DateDTYService start and end dateNot currently used.
PERClaim Contact Information
PER01Contact Function CodeANYCX - Payers Claim Office
PER02Claim Contact NameANSUser IDNot currently used.
PER03Communication Number QualifierSNot currently used.
PER04Claim Contact Communications NumberSNot currently used.
PER05Communication Number QualifierSNot currently used.
PER06Claim Contact Communications NumberSNot currently used.
PER07Telephone ExtensionSNot currently used.
PER08Communication NumberSNot currently used.