Study Charges

The following are the datasources for the report:

Procedure Code: procedure code of study charged
Procedure Description: description of study charged
Modifier: a standard code that modifies the charge submitted to billing
Quantity: number of times the study was performed
Charge Amount: amount charged for the study
Allowed Amount: allowed amount for study charge
RVU Technical: a measure of value used in the United States Medicare reimbursement formula for physician service. The technical portion include components such as the provision of equipment, supplies, personnel, and costs related to the performance of the exam.
RVU Professional: a measure of value used in the United States Medicare reimbursement formula for physician service. The professional component is provided by the physician, and may include supervision, interpretation, and a written report.
Fee Schedule: fee schedule
Fee Schedule Source: where the fee schedule originated from
Payer Name: name of payer
Payer Financial Type: payer's financial type
Payer Fee Schedule: payer's fee schedule
Payer Contact Name: payer's contact name
Payer ID: payer ID
Payer Carrier ID: payer's carrier ID
Payer Business Phone: payer's business phone
Payer Fax Number: payer's fax number
Payer Claims Phone: payer's claims phone
Payer Claims Fax Number: payer's claims fax number
Payer Benefits Phone: payer benefit's phone number
Payer Authorization Phone: payer's authorization phone number
Payer Authorization Fax Number: payer's authorization fax number
Payer Web Site: payer's website
Payer Email: payer's email
Payer Address: payer's address
Payer City: payer's city
Payer State: payer's state
Payer Country: payer's country
Payer Zip/Postal Code: payer's zip / postal code
Payer Full Address: payer's full address
Accession #: accession number
Body Parts: body part of study
Charge Status: charge status of study
Clinical Notes: clinical notes of study
Comments: additional comments
Consulting Facilities: consulting facility belonging to study
Consulting Physicians: consulting physician of study
Custom Field 1
Custom Field 2
Custom Field 3
Custom Field 4
Custom Field 5
Custom Field 6
Date
Date (UTC)
Date Addendum
Date Addendum (UTC)
Date Ordered
Date Ordered (UTC)
Date Received
Date Received (UTC)
Date Signed
Date Signed (UTC)
Date Transcribed
Date Transcribed (UTC)
Date Verified
Date Verified (UTC)
Date/Time
Date/Time (UTC)
Date/Time Addendum
Date/Time Addendum (UTC)
Date/Time Faxed
Date/Time Ordered
Date/Time Ordered (UTC)
Date/Time Read
Date/Time Read (UTC)
Date/Time Received
Date/Time Received (UTC)
Date/Time Signed
Date/Time Signed (UTC)
Date/Time Transcribed
Date/Time Transcribed (UTC)
Date/Time Verified
Date/Time Verified (UTC)
Delivery Methods
Department
Description
Fax Status
History (Symptom)
Imaging Facility
Issuer
Modalities
Performing Physician
Priority
Priority Value
Procedure Codes
Reading Facility
Reading Physician
Referring Facility
Referring Physician
Room
Scheduled Body Part
Scheduled Laterality
Scheduled Modality
Status
Status Value
Study ID
Technologist
Transcription Facility
Transcriptionist
UTC Offset
Visit Number
Account #
Account Status
Address
Birth Date
Business Phone
Cell Phone
City
Claim Contact Name
Claim Contact Phone
Contact Method
Country
Email
Emergency Contact Name
Emergency Contact Phone
Emergency Contact Relation
Employer
Employment Status
Ethnicity
Financial Type
Full Address
Guarantor Address
Guarantor Birth Date
Guarantor Business Phone
Guarantor City
Guarantor Country
Guarantor Full Address
Guarantor Contact Phone
Guarantor Name
Guarantor Relation
Guarantor Sex
Guarantor State
Guarantor Zip/Postal Code
Home Phone
Language
Marital Status
Patient Allergies
Patient ID
Patient Name
Patient Notes
Primary Insurance Payer
Race
Sex
SSN
State
Zip/Postal Code