InstaMed Connect supports the delivery of a daily file which includes a record of all healthcare transactions performed on that day, including claims, eligibility, claims status, remittance, and estimate transactions. This file is available for batch delivery and can be used for a variety of purposes, including reconciliation.
Supported Formats
The Daily Healthcare Activity File is a record of all Healthcare Transactions displayed the IDF format. Patient import transactions are excluded.
Data Flow
IDF Format Specification
| Field | Req? | Description |
|---|---|---|
| Corporate ID | Y | The Corporate ID of the account |
| Group ID | Y | The InstaMed Group ID (hierarchy underneath corporate ID for Healthcare Transactions) |
| Submission Date | Y | Date transaction was submitted |
| Transaction Type | Y | “CLAIM”, “ELIG”, “STATUS”, “REMIT”, “ESTIMATE” and reserved for future use |
| Message ID | Y | InstaMed’s assigned Message ID |
| Payer ID | N | The Payer ID |
| Note: InstaMed Payers IDs are available in InstaMed Online under User Guide ? InstaMed Payer List or using Payer List Search in EDI Enrollment | ||
| Payer Name | N | The payer Name from the transaction |
| Provider ID | N | |
| Provider Last Name | N | Provider Last or Organization Name |
| CLAIM – Billing Provider Entity | ||
| ELIG – Information Receiver | ||
| STATUS – Provider ID in Inquiry | ||
| REMIT – Billing Provider Entity | ||
| ESTIMATE – Billing Provider Entity or Service Provider Entity if Bill Provider Entity not recorded | ||
| User ID | N | If transaction entered by a user |
| Trace Number | N | Trace Number if available |
| Response Code | N | Will vary by transaction type |
| Amount | N | CLAIM – total charges |
| ESTIMATE – estimated patient responsibility | ||
| Transaction Class | N | Generally, “IN” or “OUT,” but may include “PAPER” for claims. May be used for billing |
| Charge Amount | N | CLAIM – total claim charges |
| REMIT – total submitted claim charges | ||
| ESTIMATE – total charges | ||
| (Estimated) Allowed Amount | REMIT – allowed amount | |
| ESTIMATE – estimated allowed amount | ||
| (Estimated) Patient Responsibility | N | REMIT – patient responsibility |
| ESTIMATE – estimated patient responsibility | ||
| (Estimated) Payer Responsibility | N | REMIT – payer responsibility |
| ESTIMATE – estimated payer responsibility | ||
| Patient Collected Amount | N | CLAIM – amount collected from patient |
| ELIG – amount collected from patient | ||
| REMIT – amount collected from patient | ||
| ESTIMATE – amount collected from patient | ||
| For example, from “Collect Now” functionality on eligibility or estimation, remittance is a future scope |