10
Specific Claim Multiple Year Claimants
Effective
Policy effective date.
Policyholder
Policy holder name.
Claimant
Who filed the claim.
Underwriter
Who is underwriting the policy.
Diagnosis
Patient diagnosis.
Total Billed
Total billed to the claimant.
TPA paid
Amount paid by the third party administrator.
Allowed
Allowed amount.
Spec/Laser Ded Applied
Amount of specific lasered deductible applied toward the claim.
S/F Ded Applied
Deductible applied to split funding.
Pended
Claim amount pended.
Denied
Claim amount denied.
Reimbursed
Allowed amount reimbursed.
Lasered (Y/N)
Whether or not the claimant is lasered.
Nurse Recom'd
Nurse recommended. Deductible recommended from the ESL Underwriting module.
Actual Ded
Actual deductible amount.