UCRN

Universal Claim Record Number — linking accounts to claims

UCRN (Universal Claim Record Number) is a crosswalk file format that maps patient account numbers to claim numbers. This is necessary because healthcare claims often don’t contain the account number used by the provider’s billing system.

The problem UCRN solves

When a hospital submits claims electronically (via 837 EDI), the claim is identified by a claim number (submitter ID). But the hospital’s internal billing system tracks patients by account number. These are often different identifiers.

Later, when a payer sends back a remittance (835 EDI), it references the claim number. To reconcile the payment back to the patient’s account, you need a mapping between the two.

System	Identifier	Example
Hospital billing	Account Number	67890
Submitted claim (837)	Claim Number	12345
Payer remittance (835)	Claim Number	12345
UCRN file	Maps Account → Claim	67890 → 12345

Without UCRN, there’s no way to connect the dots.

File format

UCRN files are pipe-delimited CSVs uploaded to the UCRN/ SFTP folder.

Required fields:

Field	Description	Example
Facility ID	Identifier for the healthcare facility	FAC001
Account Number	The provider’s internal billing account number	67890
Claim Number	The claim submitter ID from the 837 EDI	12345
Service Category	I (Inpatient) or O (Outpatient)	I
Pull Date	Date the crosswalk was generated	2026-02-19

Example file:

FAC001|67890|12345|I|2026-02-19
FAC001|67891|12346|O|2026-02-19
FAC001|67892|12347|I|2026-02-19

How UCRN is processed

1. File ingestion

   Our file processor reads the pipe-delimited file and creates an entity for each row with the UCRN data and customer identifier.

2. Background service picks it up

   Our account creation service subscribes to entities with UCRN data and processes them in batches.

3. Account lookup or creation

   For each UCRN entry, the service:

   1. Searches for an existing Account entity by account number
   2. If none exists, creates a new Account entity with the customer’s slug
   3. Searches for existing Claim entities by the claim submitter ID
4. Linking

   The service links Claims to Accounts via entity edges (parent-child relationships). This creates the association that allows the platform to group all claims under a patient account.

Result

After UCRN processing, Claims are linked as children of the Account:

• Account 67890
  • Claim 12345 — linked by UCRN
  • Claim 12346 — linked by UCRN
  • Claim 12347 — linked by UCRN

When remittance payments arrive later (via 835 EDI), our remittance association service can trace from the remittance’s claim number back to the Account through these links.

Customer-specific behavior

Different customers may have different account creation logic:

• Standard UCRN: Account number comes directly from the UCRN file
• Custom logic: Some customers derive account numbers from claim data (e.g., first 7 characters of the claim submitter ID)

Each service is configured per-customer to handle these variations.