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Invoice Extracted Fields Mapping
Learn which invoice data is extracted into fields with Unstructured Document Processing from the Provider Portal, including invoice dates, reference numbers, line-item amounts, quantities, prices, adjustments, and required formats.
Supported Invoice Information
Providers compare extracted values with the uploaded invoice and complete or correct supported fields before submitting a claim.
| Field | DEscription | Format |
|---|---|---|
ReferenceNumber |
The claim's invoice/reference number | Text, required |
SubmittedDate |
Invoice date | MM/DD/YYYY |
ReceivedDate |
Date the invoice was received | MM/DD/YYYY |
DueDate |
Payment due date | MM/DD/YYYY |
PaymentRequestLines[].ServiceAmount |
Line item total | Number, required per line |
PaymentRequestLines[].RequestedAmount |
Amount requested for that line | Number |
PaymentRequestLines[].AdjustmentAmount |
Discount, copay, or deductible adjustment | Number |
PaymentRequestLines[].Quantity |
Quantity of service on that line | Whole number |
PaymentRequestLines[].UnitPrice |
Price per unit on that line | Number |
PaymentRequestLines[].StartDateTime |
Service start date/time for that line | MM/DD/YYYY HH:MM:SS |
PaymentRequestLines[].EndDateTime |
Service end date/time for that line | MM/DD/YYYY HH:MM:SS |
