CMS 1500 - 文档类型

概述

CMS-1500 是医疗索赔的标准表格，非机构提供商或供应商使用该表格向医疗保险承保公司和耐用医疗设备区域承保公司 (DMERC) 开具账单。它也用于向某些州立医疗补助机构开具账单。

此 ML 包经过训练，可以自动检测关键信息，并从此类表格中提取相关数据。它包含 80 多个字段，涵盖此类表格可包含的所有类型的信息。

特殊性

该模型会自动检测以下数据：

• 付款方名称和地址。
• 患者地址、电话号码、出生日期。
• 保险公司名称和地址。
• 患病日期、理赔信息、住院日期。
• 疾病性质、诊断性质、服务日期、服务地点。

Extracted fields

备注：

If you are using using public endpoints, such as https://du.uipath.com/ie/invoices, all fields are available. However, if you are using custom-trained extractors, the availability of extracted fields is dependant on the version you are currently using. You can also check the list of fields and types on any endpoint in the /info/model object. To access this, simply add /info/model to any endpoint, like so: https://du.uipath.com/ie/invoices/info/model. For an enhanced reading experience of the fields list, it's recommended to install a JSON viewer extension in your browser.

Table 1. List of extracted fields for CMS 1500

显示名称	字段名称	字段类型	内容类型
Payment Name	payment-name	regular	字符串
Payment Address	payment-address	regular	字符串
Health Insurance Coverage Type	health-insurance-coverage-type	regular	字符串
Insured's I.D Number	insured-s-i-d-number	regular	字符串
Patient's Name	patient-name	regular	字符串
Patient's Address	patient-address	regular	字符串
Patient's Birthdate	patient-birthdate	regular	日期
Patient Relationship To Insured	patient-relationship-to-insured	regular	字符串
Insured's Name	insured-name	regular	字符串
Insured Address	insured-address	regular	字符串
Other Insured's Name	other-insured-name	regular	字符串
Other Insured's I.D.	other-insured-id	regular	字符串
Patient's Condition Related To Employment	condition-employment	regular	字符串
Patient's Condition Related To Auto Accident	condition-auto-accident	regular	字符串
Auto Accident State	auto-accident-state	regular	字符串
Insured Policy Group Or Feca Number	insured-policy-feca-id	regular	字符串
Insured's Birth Date	insured-birth-date	regular	日期
Insured's Gender	insured-sex	regular	字符串
Other Claim ID	other-claim-id	regular	字符串
Insurance Plan Name	insurance-plan-name	regular	字符串
Another Health Benefit Plan	another-health-plan	regular	字符串
Claim Codes	claim-codes	regular	字符串
Other Insurance Plan Name	other-insurance-plan	regular	字符串
Patient's Signature	patient-signature	regular	字符串
Patient's Signature Date	patient-signature-date	regular	日期
Insured's Signature	insured-signature	regular	字符串
Current Health Condition Date	health-condition-date	regular	日期
Current Health Qualifier	current-health-qualifier	regular	字符串
Other Health Condition Date	other-health-condition-date	regular	日期
Other Health Condition Qualifier	other-health-condition-qualifier	regular	字符串
Patient Unable To Work Date From	unable-to-work-date-from	regular	日期
Unable To Work To	unable-to-work-to	regular	日期
Name Of Referring Provider	name-of-referring-provider	regular	字符串
Referring Provider ID	referring-provider-id	regular	字符串
Referring Provider NPI	referring-provider-npi	regular	字符串
Hospitalization Dates From	hospitalization-dates-from	regular	日期
Hospitalization Dates To	hospitalization-dates-to	regular	日期
Additional Claim Information	additional-claim-information	regular	字符串
Services Outside Lab	services-outside-lab	regular	字符串
Charges	outside-lab-charges	regular	字符串
Diagnosis Codes	diagnosis-codes	regular	字符串
ICD Indicator	icd-indicator	regular	字符串
Resubmission Code	resubmission-code	regular	字符串
Original Reference Code	original-reference-code	regular	字符串
Prior Authorization Number	prior-authorization-number	regular	字符串
Patient's Account Number	patient-account-number	regular	字符串
Total Charge	total-charge	regular	字符串
Amount Paid	amount-paid	regular	字符串
Signature Of Physician Or Supplier	signature-of-physician-or-supplier	regular	字符串
Physician Or Supplier Signature Date	physician-supplier-signature-date	regular	日期
Service Facility Location NPI	service-location-npi	regular	字符串
Service Facility Location ID Number	service-location-id	regular	字符串
Billing Name	billing-name	regular	字符串
Billing Address	billing-address	regular	字符串
Billing Phone Number	billing-phone-number	regular	字符串
Billing NPI	billing-npi	regular	字符串
Billing ID	billing-id	regular	字符串
Patient's Phone Number	patient-phone-number	regular	字符串
Insured Phone Number	insured-phone-number	regular	字符串
Patient's Condition Related To Other Accident	condition-other-accident	regular	字符串
Reported ID Number	reported-id-number	regular	字符串
Assignment Acceptance	assignment-acceptance	regular	字符串
Patient Gender	patient-gender	regular	字符串
Federal Tax ID Number	federal-tax-id-number	regular	字符串
Service Facility Name	service-facility-name	regular	字符串
Service Facility Address	service-facility-address	regular	字符串
Medical Service Details - Date Of Service From	date-of-service-from	项目	日期
Medical Service Details - Date Of Service To	date-of-service-to	项目	日期
Medical Service Details - Place Of Service	place-of-service	项目	字符串
Medical Service Details - CPT/HCPCS	cpt-hcpcs-number	项目	字符串
Medical Service Details - Modifier	modifier	项目	字符串
Medical Service Details - Diagnosis Pointer	diagnosis-pointer	项目	字符串
Medical Service Details - Charges Amount	charges	项目	字符串
Medical Service Details - Days Or Units	days-or-units	项目	字符串
Medical Service Details - EPSDT Codes	epsdt-codes	项目	字符串
Medical Service Details - EPSDT Family Planning	epsdt-family-planning	项目	字符串
Medical Service Details - ID Qualifier	id-qualifier	项目	字符串
Medical Service Details - Rendering Provider NPI	rendering-provider-npi	项目	字符串
Medical Service Details - Rendering Provider Other ID	rendering-provider-other-id	项目	字符串
Medical Service Details - Supplemental Information	supplemental-information	项目	字符串
Medical Service Details - Emergency Indicator	emergency-indicator	项目	字符串

示例

以下是已填写表单的示例：