Internal Control Numbers (ICNs)

An Internal Control Number (ICN) is a unique 18-digit claim identifier. In Pega Smart Claims Engine, the ICN serves as the claim ID. Smart Claims Engine can automatically generate ICNs, or you may enter them manually during claim entry if you have the privilege based on system configuration.

ICNs are displayed on the banner at the top of the claim screen and are always visible while navigating a claim.

ICNs are used on outbound 835s and XML requests to third-party applications such as ClaimsXten™. ICNs are also incorporated into Put Claims and Post Claims API logic.

The metadata in an ICN includes the following information:

• The date of the claim submission to Smart Claims Engine
  • The first seven digits of the ICN represent the century, year, and Julian day that the claim was submitted to Smart Claims Engine
  • This metadata drives service-level agreement (SLA) management for the claim
• The media type of the submission
  • The eighth digit of the ICN represents the media type of the submitted claim, for example, paper or electronic batch.

    Indicator	Media type
    P	Paper
    E	Electronic batch
    V	VAN (Value added network) POS
    W	Web POS

• The sequence number
  • Digits 9-16 of the ICN represent the order the claim was received on the day it was submitted into Smart Claims Engine.
• The claim version
  • The last two digits of an ICN indicate the version; when a claim is adjusted, the version is incremented by one.

If you want to use another method for populating ICNs in Smart Claims Engine, you may extend the application to generate ICNs in accordance with your needs. When claim intake occurs through API, the API can populate ICN.