Table Detail Report
PFT_BR_EDIT_FAILURE_DETAIL
| Column Section | Relationship Section | Top of Page |
Table-level Detail
| Description: | ProFit Bill Record Edit Failure Detail |
| Definition: | Stores a list of claim scrubbing detail information for an edit failure for a bill record. |
| Table Type: | ACTIVITY |
Column Detail - PFT_BR_EDIT_FAILURE_DETAIL
| Column Name | Type | Null? | Definition |
|---|---|---|---|
| ACTIVE_IND | NUMBER | N | The table row is active or inactive. A row is generally active unless it is in an inactive state such as logically deleted, combined away, pending purge, etc. |
| BEG_EFFECTIVE_DT_TM | DATE | N | The date and time for which this table row becomes effective. Normally, this will be the date and time the row is added, but could be a past or future date and time. |
| END_EFFECTIVE_DT_TM | DATE | N | The date/time after which the row is no longer valid as active current data. This may be valued with the date that the row became inactive. |
| FAILURE_ALIAS_NAME | VC2(40) | N | The alias for the edit failure error that was returned from the scrubbing service. |
| FAILURE_ALIAS_NAME_KEY | VC2(40) | N | The indexed alias for the edit failure error that was returned from the scrubbing service. |
| FAILURE_CATEGORY_CD | NUMBER | N | Provides information about the category of the edit failure. |
| FAILURE_CATEGORY_GROUP_CD | NUMBER | N | This column provides information about the category group of the edit failure. |
| FAILURE_DESC | VC2(2000) | Y | The description for the edit failure that was returned from the scrubbing service. |
| LINE_ITEM_INDEX_NBR | NUMBER | N | The clain line item to which this failure is associated. |
| PFT_BR_EDIT_FAILURE_DETAIL_ID | NUMBER | N | Uniquely identifies detail information from the claim scrubbing for an edit failurefor a bill record. |
| PFT_BR_EDIT_FAILURE_ID | NUMBER | N | Uniquely identifies the billing record failure to which this detail is related. |
| PROVIDER_ENROLLMENT_ID | NUMBER | N | Uniquely identifies the related provider enrollment to which an edit failure detail is related. |
| RESOLUTION_ACTION_DT_TM | DATE | Y | the date time of a resolution action being applied |
| RESOLUTION_ACTION_FLAG | NUMBER | N | the indicator denoting the resolution action applied. 0 = Default, 1 = Cancel and Regenerate Claim, 2 = Ignore |
| RESOLUTION_ACTION_PRSNL_ID | NUMBER | N | the personnel Id applying the resolution action |
| SEVERITY_CATEGORY_TEXT | VC2(100) | Y | The severity reason category for the edit failure. |
| SEVERITY_CD | NUMBER | N | Contains the severity code of the edit failure. |
| SEVERITY_TEXT | VC2(100) | Y | *** OBSOLETE *** This field is no longer supported and should not be used. |
| UPDT_APPLCTX | NUMBER | N | The application context number from the record info block. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic. |
| UPDT_CNT | NUMBER | N | Set to 0 on insert. Incremented by 1 on update. Used to recognize update conflict where data in a row updated by one application is at risk of being lost by a second application attempting to update the row. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic. |
| UPDT_DT_TM | DATE | N | The date and time the row was last inserted or updated. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic. |
| UPDT_ID | NUMBER | N | The person_id of the person from the personnel table (prsnl) that caused the last insert or update of the row in the table. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic. |
| UPDT_TASK | NUMBER | N | The registered (assigned) task number for the process that inserted or updated the row. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic. |
Relationship Detail - PFT_BR_EDIT_FAILURE_DETAIL
| Child Column in PFT_BR_EDIT_FAILURE_DETAIL(FK) | Parent Table Name | Parent Column Name | |
|---|---|---|---|
| Parents: | PFT_BR_EDIT_FAILURE_ID | PFT_BR_EDIT_FAILURE | PFT_BR_EDIT_FAILURE_ID |
| PROVIDER_ENROLLMENT_ID | PROVIDER_ENROLLMENT | PROVIDER_ENROLLMENT_ID | |
| RESOLUTION_ACTION_PRSNL_ID | PRSNL | PERSON_ID |
PFT_BR_LINE_STATUS_DETAIL
| Column Section | Relationship Section | Top of Page |
Table-level Detail
| Description: | ProFit Bill Record Claim Line Status Detail |
| Definition: | Stores the claim line acknowledgements from the payer. |
| Table Type: | ACTIVITY |
Column Detail - PFT_BR_LINE_STATUS_DETAIL
| Column Name | Type | Null? | Definition |
|---|---|---|---|
| ACTIVE_IND | NUMBER | Y | The table row is active or inactive. A row is generally active unless it is in an inactive state such as logically deleted, combined away, pending purge, etc. |
| ADDL_STATUS_INFO_TXT | VC2(1000) | Y | Stores additional status information. |
| CREATED_DT_TM | DATE | Y | The date and time this row was created. |
| PFT_BR_CLAIM_STATUS_DETAIL_ID | NUMBER | Y | Uniquely identifies the related row on the PFT_BR_CLAIM_STATUS_DETAIL table. |
| PFT_BR_LINE_STATUS_DETAIL_ID | NUMBER | N | A system generated number used to uniquely identify a row on the PFT_BR_LINE_STATUS_DETAIL table. |
| PFT_LINE_ITEM_ID | NUMBER | Y | Uniquely identifies the related row on the PFT_LINE_ITEM table. |
| SVC_LINE_ENTITY_CD | NUMBER | Y | Stores the entity code for the claim line. |
| SVC_LINE_STATUS_CATEGORY_CD | NUMBER | Y | Indicates the general category of a claim line status. |
| SVC_LINE_STATUS_CATEGORY_TXT | VC2(30) | Y | Indicates the general category in a textual format of a claim line status. |
| SVC_LINE_STATUS_CD | NUMBER | Y | This code conveys the staus of a claim line item. |
| SVC_LINE_STATUS_DT_TM | DATE | Y | The date and time of the status codes that were sent in from upstream. |
| SVC_LINE_STATUS_TXT | VC2(30) | Y | Conveys the status of a claim line item in a textual format. |
| UPDT_APPLCTX | NUMBER | Y | The application context number from the record info block. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic. |
| UPDT_CNT | NUMBER | Y | Set to 0 on insert. Incremented by 1 on update. Used to recognize update conflict where data in a row updated by one application is at risk of being lost by a second application attempting to update the row. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic. |
| UPDT_DT_TM | DATE | Y | The date and time the row was last inserted or updated. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic. |
| UPDT_ID | NUMBER | Y | The person_id of the person from the personnel table (prsnl) that caused the last insert or update of the row in the table. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic. |
| UPDT_TASK | NUMBER | Y | The registered (assigned) task number for the process that inserted or updated the row. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic. |
Relationship Detail - PFT_BR_LINE_STATUS_DETAIL
| Child Column in PFT_BR_LINE_STATUS_DETAIL(FK) | Parent Table Name | Parent Column Name | |
|---|---|---|---|
| Parents: | PFT_BR_CLAIM_STATUS_DETAIL_ID | PFT_BR_CLAIM_STATUS_DETAIL | PFT_BR_CLAIM_STATUS_DETAIL_ID |
| PFT_LINE_ITEM_ID | PFT_LINE_ITEM | PFT_LINE_ITEM_ID |
PFT_CHARGE
| Column Section | Relationship Section | Top of Page |
Table-level Detail
| Description: | ProFit Charge |
| Definition: | Represents the fact that a charge has posted into ProFit Billing system. |
| Table Type: | ACTIVITY |
Column Detail - PFT_CHARGE
| Column Name | Type | Null? | Definition |
|---|---|---|---|
| ACTIVE_IND | NUMBER | Y | The table row is active or inactive. A row is generally active unless it is in an inactive state such as logically deleted, combined away, pending purge, etc. |
| ACTIVE_STATUS_CD | NUMBER | N | Indicates the status of the row itself (not the data in the row) such as active, inactive, combined away, pending purge, etc. |
| ACTIVE_STATUS_DT_TM | DATE | Y | The date and time that the active_status_cd was set. |
| ACTIVE_STATUS_PRSNL_ID | NUMBER | N | The person who caused the active_status_cd to be set or change. |
| ACTIVITY_ID | NUMBER | N | FK to the activity_log |
| ALT_BILLING_AMT | FLOAT | N | Charge billing amount as calculated using an alternate formula |
| ALT_BILLING_QTY | NUMBER | N | Charge quantity as calculated using alternate formula |
| BEG_EFFECTIVE_DT_TM | DATE | Y | The date and time for which this table row becomes effective. Normally, this will be the date and time the row is added, but could be a past or future date and time. |
| BE_ORG_ID | NUMBER | N | FK to the organization table |
| BILLING_AMOUNT | FLOAT | Y | This field reflects the total charge amount minus the credit charges made to this charge. |
| BILLING_ENTITY_ID | NUMBER | N | FK to the billing_entity table |
| BILLING_QUANTITY | NUMBER | Y | This field reflects the total number of items a charge is for minus the credit charges made to this charge. |
| BO_GEN_IND | NUMBER | Y | The indicator that describes if the charge group has generated a claim with the charge on it. |
| CHARGE_ITEM_ID | NUMBER | N | FK to the charge table |
| CLIENT_BILL_IND | NUMBER | Y | Indicates if the charge will be billed for a client account. |
| CLIENT_ORG_ID | NUMBER | N | FK to the organization table |
| COLLECTION_PRIORITY_CD | NUMBER | N | Describes the priority of collection. |
| CR_ACCT_ID | NUMBER | N | The revenue account associated to the charge. |
| CR_ACCT_TEMPL_ID | NUMBER | N | The account template assigned to the revenue account. |
| DR_ACCT_ID | NUMBER | N | The A/R account associated to the charge. |
| DR_ACCT_TEMPL_ID | NUMBER | N | The account template assigned to the A/R account. |
| ENCNTR_TYPE_CD | NUMBER | N | Code value indicating the type of encounter (e.g. Inpatient, outpatient). |
| END_EFFECTIVE_DT_TM | DATE | Y | The date/time after which the row is no longer valid as active current data. This may be valued with the date that the row became inactive. |
| EXT_BILLED_IND | NUMBER | N | Stores the external_billed_ind value - The value is set to 1 if the charge is billed by the external system, 0 otherwise |
| INST_FIN_NBR_KEY | VC2(250) | Y | The financial number associated to the charges encounter. |
| INTERFACE_ID | NUMBER | N | FK to the csi_log |
| LATE_CHRG_FLAG | NUMBER | Y | Describes if the charge was posted after billing has begun. 0 = Not a late charge; 1 = debit late charge; 3 = PBM credit late charge; 4 = adjusted late charge; 5 = manual late charge; 7 = credit late charge; 9 = Regenerate all charges |
| MOVE_CHRG_IND | NUMBER | N | ** obsolete ** No longer used. Indicates wheather charge moved from one financial encounter to another. ** obsolete ** |
| MV_ORIG_CHRG_ITEM_ID | NUMBER | Y | This Column will be populated with charge item id of the charge which has been moved for the first time.2. Any other workflow on same charge like move charge, financial combine or encntr_mod will copy the same value which has been persisted for first time. |
| OFFSET_IND | NUMBER | Y | Describes if the charge has been offset. |
| ORIGINAL_UPDT_CNT | NUMBER | Y | Value of the update count on the inserted row. |
| PACKAGE_PFT_CHARGE_ID | NUMBER | N | Uniquely identifies the pft_charge related to this package. |
| PARENT_ENTITY_ID | NUMBER | N | Identifies the name of the parent entity. |
| PATIENT_LOC_CD | NUMBER | N | Code value identifying the location of the patient. |
| PFT_CHARGE_ID | NUMBER | N | Primary Key |
| PFT_CHARGE_STATUS_CD | NUMBER | N | Describes the current status of the charge. |
| PFT_CHARGE_STATUS_REASON_CD | NUMBER | N | Describes the status reason for the charge. |
| PFT_ENCNTR_ID | NUMBER | N | FK to the pft_encntr table |
| PFT_ENCNTR_IND | NUMBER | Y | ProFit Encounter Table |
| REPORT_PRIORITY_CD | NUMBER | N | Describes the priority of the report. |
| SERVICE_RESOURCE_CD | NUMBER | N | Identifies the Service Resource Code related to this record. |
| UPDT_APPLCTX | NUMBER | N | The application context number from the record info block. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic. |
| UPDT_CNT | NUMBER | N | Set to 0 on insert. Incremented by 1 on update. Used to recognize update conflict where data in a row updated by one application is at risk of being lost by a second application attempting to update the row. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic. |
| UPDT_DT_TM | DATE | N | The date and time the row was last inserted or updated. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic. |
| UPDT_ID | NUMBER | N | The person_id of the person from the personnel table (prsnl) that caused the last insert or update of the row in the table. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic. |
| UPDT_TASK | NUMBER | N | The registered (assigned) task number for the process that inserted or updated the row. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic. |
Relationship Detail - PFT_CHARGE
| Child Column in PFT_CHARGE(FK) | Parent Table Name | Parent Column Name | |
|---|---|---|---|
| Parents: | CR_ACCT_ID | ACCOUNT | ACCT_ID |
| DR_ACCT_ID | ACCOUNT | ACCT_ID | |
| CR_ACCT_TEMPL_ID | ACCT_TEMPLATE | ACCT_TEMPL_ID | |
| DR_ACCT_TEMPL_ID | ACCT_TEMPLATE | ACCT_TEMPL_ID | |
| ACTIVITY_ID | ACTIVITY_LOG | ACTIVITY_ID | |
| BILLING_ENTITY_ID | BILLING_ENTITY | BILLING_ENTITY_ID | |
| CHARGE_ITEM_ID | CHARGE | CHARGE_ITEM_ID | |
| MV_ORIG_CHRG_ITEM_ID | CHARGE | CHARGE_ITEM_ID | |
| INTERFACE_ID | CSI_LOG | INTERFACE_ID | |
| BE_ORG_ID | ORGANIZATION | ORGANIZATION_ID | |
| CLIENT_ORG_ID | ORGANIZATION | ORGANIZATION_ID | |
| PACKAGE_PFT_CHARGE_ID | PFT_CHARGE | PFT_CHARGE_ID | |
| PFT_ENCNTR_ID | PFT_ENCNTR | PFT_ENCNTR_ID |
| Parent Column in PFT_CHARGE (PK) | Child Table Name | Child Column Name | |
|---|---|---|---|
| Children: | PFT_CHARGE_ID | CSI_ERROR_LOG | PFT_CHARGE_ID |
| PFT_BALANCE | PFT_CHARGE_ID | ||
| PFT_BILL_ACTIVITY | PFT_CHARGE_ID | ||
| PFT_CHARGE | PACKAGE_PFT_CHARGE_ID | ||
| PFT_CHARGE_BO_RELTN | PFT_CHARGE_ID | ||
| PFT_CHARGE_GLOBAL_DAYS | PFT_CHARGE_ID | ||
| PFT_DAILY_BO_HP_CHRG_BAL | PFT_CHARGE_ID | ||
| PFT_LINE_ITEM_CHRG_RELTN | PFT_CHARGE_ID |
PFT_CHARGE_BO_RELTN
| Column Section | Relationship Section | Top of Page |
Table-level Detail
| Description: | ProFit Charge Benefit Order Relation |
| Definition: | Identifies a charge(pft_charge_id) as being a member of the charge group identified by benefit_order_id, including any billing information that is specific to this relationship (such as the health plan coverage of the charge for the coordination of benefits represented by the charge group). |
| Table Type: | ACTIVITY |
Column Detail - PFT_CHARGE_BO_RELTN
| Column Name | Type | Null? | Definition |
|---|---|---|---|
| ACTIVE_IND | NUMBER | Y | The table row is active or inactive. A row is generally active unless it is in an inactive state such as logically deleted, combined away, pending purge, etc. |
| ACTIVE_STATUS_CD | NUMBER | N | Indicates the status of the row itself (not the data in the row) such as active, inactive, combined away, pending purge, etc. |
| ACTIVE_STATUS_DT_TM | DATE | Y | The date and time that the active_status_cd was set. |
| ACTIVE_STATUS_PRSNL_ID | NUMBER | N | The person who caused the active_status_cd to be set or change. |
| ADJUDICATED_STATUS_CD | NUMBER | N | Status of adjudication for the charge |
| BEG_EFFECTIVE_DT_TM | DATE | Y | The date and time for which this table row becomes effective. Normally, this will be the date and time the row is added, but could be a past or future date and time. |
| BENEFIT_ORDER_ID | NUMBER | N | FK to the benefit_order table |
| BILL_TEMPL_ID | NUMBER | N | FK to the bill_templ table |
| BT_COND_RESULT_ID | NUMBER | N | FK to the bt_cond_result table as of iteration 2.2 no longer used |
| COVERED_BITMAP | NUMBER | N | This column utilizes bit manipulation to determine whether a charge is covered by the associated health plan. |
| COVERED_IND | NUMBER | Y | Covered Indicator |
| DENIED_IND | NUMBER | Y | ** obsolete ** This column is no longer used. Denied Indicator |
| DENIED_REASON_CD | NUMBER | N | ** obsolete ** This column is no longer used. Denied Reason Code |
| END_EFFECTIVE_DT_TM | DATE | Y | The date/time after which the row is no longer valid as active current data. This may be valued with the date that the row became inactive. |
| PFT_CHARGE_BO_RELTN_ID | NUMBER | N | Primary Key |
| PFT_CHARGE_ID | NUMBER | N | FK to the pft_charge table |
| UPDT_APPLCTX | NUMBER | N | The application context number from the record info block. |
| UPDT_CNT | NUMBER | N | Set to 0 on insert. Incremented by 1 on update. Used to recognize update conflict where data in a row updated by one application is at risk of being lost by a second application attempting to update the row. |
| UPDT_DT_TM | DATE | N | The date and time the row was last inserted or updated. |
| UPDT_ID | NUMBER | N | The person_id of the person from the personnel table (prsnl) that caused the last insert or update of the row in the table. |
| UPDT_TASK | NUMBER | N | The registered (assigned) task number for the process that inserted or updated the row. |
Relationship Detail - PFT_CHARGE_BO_RELTN
| Child Column in PFT_CHARGE_BO_RELTN(FK) | Parent Table Name | Parent Column Name | |
|---|---|---|---|
| Parents: | BENEFIT_ORDER_ID | BENEFIT_ORDER | BENEFIT_ORDER_ID |
| BILL_TEMPL_ID | BILL_TEMPL | BILL_TEMPL_ID | |
| PFT_CHARGE_ID | PFT_CHARGE | PFT_CHARGE_ID |
PFT_CHRG_GRP_RPRCS
| Column Section | Relationship Section | Top of Page |
Table-level Detail
| Description: | PFT Charge Group Reprocess |
| Definition: | Stores balance information along with encounter details to reprocess through WTP server. |
| Table Type: | ACTIVITY |
Column Detail - PFT_CHRG_GRP_RPRCS
| Column Name | Type | Null? | Definition |
|---|---|---|---|
| BALANCE_STATUS_TXT | VC2(40) | Y | State of the balance at a particular instance of time |
| BATCH_REPROCESSING_STATUS_FLAG | NUMBER | N | Batch reprocessing status as pending,In Progress, Error and Completed. |
| BENEFIT_ORDER_ID | NUMBER | N | System defined unique identifier of a benefit order. |
| BILLING_ENTITY_ID | NUMBER | N | Uniquely identifies the related Billing Entity. |
| BILLING_ENTITY_NAME | VC2(50) | Y | Allows for the billing entity to have a different name than the organization that it is related to. |
| BT_CONDITION_ID | NUMBER | N | Uniquely identifies each bill template condition. |
| CHARGE_GROUP_AMT | FLOAT | Y | The current amount due for this that particular balance. |
| CHARGE_GROUP_NAME | VC2(200) | Y | Contains the name of a particular bill template condition. |
| CREATED_ID | NUMBER | N | Uniquely identifies the related personnel who created the record. |
| ENCOUNTER_ALIAS_NAME | VC2(215) | Y | Stores the financial encounter's alias which will be used to identify the financial encounter. |
| ENCOUNTER_BALANCE_AMT | FLOAT | Y | Balance related to a profit encounter. |
| ENCOUNTER_STATUS_TXT | VC2(40) | Y | Encounter status identifies the state of a particular encounter type from the time it is initiated until it is complete. (i.e., temporary, preliminary, active, discharged (complete), cancelled). |
| ENCOUNTER_TYPE_TXT | VC2(40) | Y | Categorizes the encounter into a logical group or type. examples may include inpatient, outpatient, etc. |
| FAILURE_REASON_FLAG | NUMBER | Y | If the reprocess fail, this column displays reason why it failed. |
| HEALTH_PLAN_NAME | VC2(100) | Y | Name of the related health plan. |
| LOGICAL_DOMAIN_ID | NUMBER | N | The unique identifier for a logical domain. This identifier allows the data to be grouped by logical domain. For example, If you assign clients a logical_domain_id this would allow you to store data for multiple clients on this table. |
| PFT_CHRG_GRP_RPRCS_ID | NUMBER | N | System Generated Number to Uniquely Identify a Row on the PFT_CHRG_GRP_RPRCS table. |
| PFT_ENCNTR_ID | NUMBER | N | Uniquely identifies the related profit encounter record |
| REPORT_FILE_NAME | VC2(100) | Y | Contains file name where for reporting need after reprocess. |
| REPROCESSING_STATUS_FLAG | NUMBER | Y | Reprocessing status for each balance like Failure or Success. |
| SLICE_GRP_VALUE | NUMBER | N | Load balancing slice number for reprocess using WTP |
| UPDT_APPLCTX | NUMBER | N | The application context number from the record info block. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic. |
| UPDT_CNT | NUMBER | N | Set to 0 on insert. Incremented by 1 on update. Used to recognize update conflict where data in a row updated by one application is at risk of being lost by a second application attempting to update the row. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic. |
| UPDT_DT_TM | DATE | N | The date and time the row was last inserted or updated. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic. |
| UPDT_ID | NUMBER | N | The person_id of the person from the personnel table (prsnl) that caused the last insert or update of the row in the table. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic. |
| UPDT_TASK | NUMBER | N | The registered (assigned) task number for the process that inserted or updated the row. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic. |
| USER_BATCH_GRP_VALUE | NUMBER | N | User based batch number for reprocess |
Relationship Detail - PFT_CHRG_GRP_RPRCS
| Child Column in PFT_CHRG_GRP_RPRCS(FK) | Parent Table Name | Parent Column Name | |
|---|---|---|---|
| Parents: | BENEFIT_ORDER_ID | BENEFIT_ORDER | BENEFIT_ORDER_ID |
| BT_CONDITION_ID | BT_CONDITION | BT_CONDITION_ID | |
| LOGICAL_DOMAIN_ID | LOGICAL_DOMAIN | LOGICAL_DOMAIN_ID | |
| PFT_ENCNTR_ID | PFT_ENCNTR | PFT_ENCNTR_ID | |
| CREATED_ID | PRSNL | PERSON_ID |