---
sourceDocument: Australia Healthcare and Life Sciences
sourceDocumentLink: https://servicenow-prod.fluidtopics.net/r/de-DE/healthcare-life-sciences

 Release :

    - australia

ft:locale :

    - de-DE

ft:publication_title :

    - Australia Healthcare and Life Sciences

ft:clusterId :

    - hcls

bundleId :

    - hcls

workflow :

    - Customer and Industry


---

# Claim header table

# Claim header table {#ariaid-title1}

* Freigeben Version: Australia
* 
* Aktualisiert 12. März 2026
* 
* ![](https://www.servicenow.com/docs/portal-asset/ico-clock) 2 Minuten Lesedauer

The Claim header \[sn_hcls_claim_header\] table stores the details of the main claim submitted on behalf of a patient to a payer organization. {#hcls-claim-header-table__claim-header-table-sd}
The table has the following features:

* Stores the main claim submitted on behalf of a patient to a payer organization.
* Enables including multiple claim lines.
* Includes the payer, transaction control number, type, status, patient, member plan, medical record number, account number, and various dates and amounts.

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Role required to configure the table: sn_hcls.admin.

For more information, see Healthcare and Life Sciences data model.
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| Field | Data type | Description |
|-|-|-|
| Adjudicated amount | Currency | Adjusted amount paid for the service by the primary payer. |
| Billed DRG code | String | Diagnosis Related Group (DRG) code for the billed diagnosis-related group. |
| Claim amount | Currency | Original amount submitted with the claim. |
| Date accepted | Date | Date when the claim was accepted by the payer organization. |
| Date adjudicated | Date | Date when the claim was adjudicated for the payment. |
| Date paid | Date | Date when the claim was paid by the payer organization. |
| Date submitted | Date | Date when the claim was submitted to the payer organization. |
| Fee reduction amount | Currency | Difference between the original claim amount and the adjusted paid amount. |
| Medical record number | String | Medical Record Number (MRN) of the patient as entered in the electronic medical records (EMR) system. |
| Member plan | Reference | Member plan associated with the patient. |
| Name | String | Name to identify the claim header. |
| Number | String | Alpha-numeric profile identifier of the claim header. The value is auto-generated and is incremented every time you add a new claim header to an instance. The initial value for the Number field is CLAIMHDR00001001. Hinweis: To customize the number, define the auto-numbering format for the Claim header \[sn_hcls_claim_header\] table. For more information, see [Add auto-numbering records in a table](https://www.servicenow.com/docs/access?context=t_AutoNumberingRecordsInATable&version=australia&pubname=australia-platform-administration&ft:locale=en-US). |
| Paid amount | Currency | Amount to be paid by the patient. |
| Patient | Reference | Patient on whose behalf the claim was submitted. |
| Patient account number | String | Patient account number as entered in the EMR system. |
| Patient payable amount | Currency | Amount for which the patient is responsible. |
| Payer | Reference | Name of the company listed as a payer organization. |
| Preauthorization header | Reference | Associated pre-authorization request. |
| Prior authorization id | String | Reference number previously provided by the insurer to the provider to be quoted on subsequent claims containing services or products related to the prior authorization. |
| Remarks | String | Comments or additional information about the claim. |
| Service provider | Reference | Practitioner who provided the service to the patient. |
| Service provider id | String | Identifier of the practitioner who provided the product or service to the patient. |
| Source | Reference | Source system details of an external healthcare system in a ServiceNow instance. |
| Status | Choice list | Status of the claim. The following statuses are available by default: * Active * Cancelled * Denied * Draft * Entered in error * In hold * Paid * Suspended {#hcls-claim-header-table__ul_fcn_hfl_ppb} For more information about the available statuses, see [claim statuses](http://hl7.org/fhir/2016sep/codesystem-claim-status.html) defined in the FHIR specifications. |
| Transaction control number | String | Unique identifier of the claim in the payer system. |
| Type | Choice list | Type of the claim. The following types are available by default: * Institutional * Oral * Pharmacy * Professional * Vision {#hcls-claim-header-table__ul_d2q_cgl_ppb} For more information about the available claim types, see [claim types](https://www.hl7.org/fhir/valueset-claim-type.html) defined in the FHIR specifications. |
[Tabelle : 1. Claim header table fields]

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