Daily Healthcare Activity File

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

FieldReq?Description
Corporate IDYThe Corporate ID of the account
Group IDYThe InstaMed Group ID (hierarchy underneath corporate ID for Healthcare Transactions)
Submission DateYDate transaction was submitted
Transaction TypeY“CLAIM”, “ELIG”, “STATUS”, “REMIT”, “ESTIMATE” and reserved for future use
Message IDYInstaMed’s assigned Message ID
Payer IDNThe 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 NameNThe payer Name from the transaction
Provider IDN
Provider Last NameNProvider 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 IDNIf transaction entered by a user
Trace NumberNTrace Number if available
Response CodeNWill vary by transaction type
AmountNCLAIM – total charges
ESTIMATE – estimated patient responsibility
Transaction ClassNGenerally, “IN” or “OUT,” but may include “PAPER” for claims. May be used for billing
Charge AmountNCLAIM – total claim charges
REMIT – total submitted claim charges
ESTIMATE – total charges
(Estimated) Allowed AmountREMIT – allowed amount
ESTIMATE – estimated allowed amount
(Estimated) Patient ResponsibilityNREMIT – patient responsibility
ESTIMATE – estimated patient responsibility
(Estimated) Payer ResponsibilityNREMIT – payer responsibility
ESTIMATE – estimated payer responsibility
Patient Collected AmountNCLAIM – 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