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SD and SF Reports Mapping

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To access the SD or SF report in the ConnectCenter:

  1. Log in to ConnectCenter.
  2. Click Help >> API Documentation >> Responses and Reports >> Claims >> Reports >> Select SD or SF for mapping.

SD payer batch totals data file

The Payer Batch Totals Data File (SD) report presents payer batch information in a standard, delimited data file format.

The elements in the data file vary in length. Each element is delimited by a pipe (|) character and is given a reference number in the Element Number column. The elements in the data file will be populated only if returned by the payer on their reports. Each record ends with a carriage return/line feed. One data file will be created for each report. Elements highlighted in gray, 14 through 29, will not populate in the Payer Batch Totals Report (SB).

The SD and SF reports include the information in the following format:

Element NumberElement NameMaximum Element SizeDescription

📘

NOTE

SD report naming convention: SDnnnnnn.xx, where, nnnnnn is the Optum assigned Submitter ID and xx is an incremented two-byte file extension.

For the Payer Batch Totals Data File (SD) report, you can repeat the following data, zero to many times depending on how many claims are tied to the batch. If the claim data cannot be tied back to the batch file, then no detail records will be created.

Element NumberElement NameMaximum Element SizeDescription
1Record Code1D for detail information Populated by data extracted from Optum.
2Patient Control Number30Populated by data extracted from Optum.
3Patient Last Name35Populated by data extracted from Optum.
4Patient First Name25Populated by data extracted from Optum.
5Patient Middle Name25Populated by data extracted from Optum.
6Claim From Date8Format: CCYYMMDD
Populated by data extracted from Optum.
7Claim To Date8Format: CCYYMMDD
Populated by data extracted from Optum.
8Claim Charge Amount21
  • the decimal point; includes leading and trailing zeros
  • a leading sign (+ for positive values; - for negative values)
    • (for example, a $15 charge would be represented as: +000000000000015.00)
    Populated by data extracted from Optum.
    9Policy Number30Populated by data extracted from Optum.
    10Submitter Assign Claim ID30Claim identification number from client Populated by data extracted from Optum.
    11TSH Unique Claim ID13Transaction Solution Hub (TSH) is the Optum-assigned unique claim ID populated by data extracted from Optum.
    12Type of Bill3Populated by data extracted from Optum.
    13Group Number30Populated by data extracted from Optum.

    Sample payer batch totals data file

    B|9999|123456|123456|CHI03|9999|20080617|222222|20080422|||1225557890|||||||||||||||||2074|ACCEPTED|000002||000002| 00000999.54|000000|||||
PAYOR REPORTH99RAR04 BATCH DETAIL CONTROL LISTING D|123456-99|SMITH|BRIAN||20061105|20061105| 
00000000000000999.00|XXBB12345XX|1354578915651|0632599999999|| 
D|234567-99|SAY|ELIZABETH|M|20061015|20061015| 00000000000000999.00|FFF66666CCC|
5432154321245|0632514565656|| D|345678-99|HI|LONG|M|20061010|20061010| 00000000000000222.00|
3456789098|4444444445555|6767676767676||141414 D|456789-99|SMITH|RAYMOND||20061112|20061112| 
00000000000000555.00|WWWLLLDDD23|4564545454545|0632578787878||68686868686868 D|
678902454545|SIMMONS|NANCY|B|20061109|20061109| 00000000000008989.00|187767676||0632545454545|| 
B|9999|123456|123456|CHI03|9999|20080617|676767|20020088|||1535656565|||||||||||||||||
3926|ACCEPTED|000022||000022| 00003333.88|000000|||||PAYOR REPORTH99RAR04 BATCH DETAIL CONTROL LISTING B|
9999|123456|123456|CHI03|9999|20080617|111815|20020088|||1700801966|||||||||||||||||5079|
ACCEPTED|000015||000015| 00003920.78|000000|||||IL MEDICARE H99RAR04 BATCH 
DETAIL CONTROL LISTING D|123456-99|SMITH|BRIAN||20061105|20061105| 
00000000000000999.00|XXBB12345XX|1354578915651|0632599999999|| 
D|234567-99|SAY|ELIZABETH|M|20061015|20061015| 00000000000000999.00|
FFF66666CCC|5432154321245|0632514565656||

    SF payer report data file (normalized)

    This Payer Report Data File (SF) report presents payer claim information in a standard, delimited data file format.

    📘

    NOTE

    SF report naming convention: SFnnnnnn.xx, where nnnnnn is the Optum-assigned Submitter ID and xx is an incremented two byte file extension.

    The elements in the data file vary in length. Each element is delimited by a pipe (|) character and given a reference number in the Element Number column. Most of the elements in the data file will be populated only if returned by the payer on their reports. Elements 44 through 54 will be populated from the originally submitted claim data when the claim can be uniquely identified by Optum. Each record ends with a carriage return/line feed. Elements highlighted in gray, will not populate in the Payer Claim Data Report (SR) except when the SR Patient Control Number is preceded by an asterisk (*).

    Sample payer report data file

    9999|209999|079999|CHI01|3429|20090324|064500|9999A 260|GREEN|LUIS|A|20081203|20081203| 000000000000210.10|20090324|WHITE HOBDY||1851349999||||||||922379999|0907911308515079999|A1:19:PR:65|M - INFORMATIONAL|||||||||090791130PPPP|090791130PPPP|A1:19:PR:65| ACK,RECPT- CLM,ENCOUNTER RECEIVED. DOES NOT MEAN THAT CLM HAS BEEN ACCEPTD FOR ADJUDICATION.:ENTITY ACKNOWLEDGES RECEIPT OF CLAIM, ENCOUNTER.||277 DATA FILE||660689999|0001|9999A 260|GREEN|LUIS|A|20089999|20089999| 000000000000210.10|922379999|1851349999||||

9999|209999|079999|CHI01|3429|20090324|064500|9999A 260|GREEN|LUIS|A|20081210|20089999| 000000000000210.10|20099999|WHITE HOBDY||1851349999||||||||922379999|0907911308516079999|A1:19:PR:65|M - INFORMATIONAL|||||||||0907911309999|0907911309999|A1:19:PR:65| ACK,RECPT- CLM,ENCOUNTER RECEIVED. DOES NOT MEAN THAT CLM HAS BEEN ACCEPTD FOR ADJUDICATION.:ENTITY ACKNOWLEDGES RECEIPT OF CLAIM, ENCOUNTER.||277 DATA FILE||660689999|0001|9999A 260|GREEN|LUIS|A|20081210|20081210| 000000000000210.10|922379999|1851349999||||

    Field Description

    • Payer ID — You will recognize this as the four-digit CPID of the payer as found on payer list.
    • Billing ID — An internal number set up with our accounting department that is used for invoicing.
    • Submitter ID — Your six-digit submitter number. It is set up when we send out production credentials.
    • System ID — An internal number associated with the clearinghouse.
    • TSH Unique Claim ID — A product name for our back-end solution. In regard to the claim ID, it is the 13-digit number you find on your claim that is assigned by Optum (level III editing).
    • Type of Bill — Is sent on a claim by the provider and can be returned by the payer. It basically indicates where services were rendered. The Type of Bill Code structure is a four-digit alphanumeric code providing three specific pieces of information after the leading zero. CMS ignores the leading zero.
      • First Digit – Leading zero. Ignored by CMS (not included on claim)
      • Second Digit – Type of facility
      • Third Digit – Type of care
      • Fourth Digit – Sequence of this bill in this episode of care. Referred to as a "frequency code"

    Updated 13 days ago