Claim Submission Objects and Fields

Review the Objects and Fields used in the Service Provider Portal.

Object	Fields
Authorized Product Delivery	Claim Item, Status, Provider, Constituent
Claim	Status, Account, Payment Instrument, Initiation Date, Claim Type, Estimated Amount, Claim Reason, Actual Amount, Approved Amount, Loss Date, Summary
Claim Item	Provider, Start Date, Quantity, Product, End Date, Unit of Measure
Document Checklist	Extracted Data
Healthcare Provider	Account
Payment Instrument	Account, Account Holder, Last 4, Status, Is Default
Payment Line Request	Service Amount, Unit Price, Start Date/Time, End Date/Time, Requested Amount, Adjustment Amount, Quantity
Payment Request	Claim ID, Received Date, Start Date/Time, End Date/Time, Reference Number, Submitted Date, Due Date

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