Specific Reserves

Effective

Policy effective date.

Policyholder

Policy holder name.

Policyholder state

Claimant

Who made the claim.

Diagnosis

Patient diagnosis.

C/B

Policy contract basis.

Whether or not the claim is or includes a notice.

TPA Paid Claims

Claim amount paid by the third party administrator.

Deduct

Policy deductible.

Split Funding

Split funding amount, if any.

Unallow

Amount disallowed on the claim.

Pending

Amount pending on the claim.

Reimb

Amount reimbursed on the claim.

Pending Reimb

Reimbursement amount pending.

Outstanding

Payment amount still outstanding.

Reserves

Reserve amount on the claim.