BENEFIT
| Column Section | Relationship Section | Top of Page |
Table-level Detail
| Description: | BENEFIT |
| Definition: | A benefit related to a base health plan or to an employer-tailored plan |
| Table Type: | REFERENCE |
Column Detail - BENEFIT
| Column Name | Type | Null? | Definition |
|---|---|---|---|
| ACTIVE_IND | DOUBLE | 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 | DOUBLE | Y | 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 | DATETIME | Y | The date and time that the active_status_cd was set. |
| ACTIVE_STATUS_PRSNL_ID | DOUBLE | Y | The person who caused the active_status_cd to be set or change. |
| BEG_EFFECTIVE_DT_TM | DATETIME | 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. |
| BENEFIT_ID | DOUBLE | N | Unique identifier for a benefit category |
| BENEFIT_MOD_FLAG | DOUBLE | N | Indicates whether the benefit record adds to an existing benefit, nullifies an existing benefit, or changes an existing benefit |
| BNFT_TYPE_CD | DOUBLE | N | Code value representing a benefit category (type of benefit) |
| DX_CODE_MAX | VARCHAR(50) | Y | The highest diagnosis code of a range of codes for which this benefit applies |
| DX_CODE_MIN | VARCHAR(50) | Y | The minimum diagnosis code of a range for which this benefit applies. |
| DX_DESCRIPTION | VARCHAR(100) | Y | Description of the diagnosis for which this benefit applies. |
| END_EFFECTIVE_DT_TM | DATETIME | Y | The date/time after which the row is no longer valid as active current data.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. |
| ORG_PLAN_RELTN_ID | DOUBLE | N | Foreign key to the org_plan_reltn table. Identifies the relationship to which this benefit is tied. |
| PARENT_BNFT_ID | DOUBLE | Y | The ID of the benefit to which this benefit is related |
| SOFT_BENEFIT_TEXT | VARCHAR(200) | Y | Text description of a benefit |
| SPECIALTY_CD | DOUBLE | Y | The code value for the specialty for which this benefit applies if it is a specialty related benefit. |
| SUB_TYPE_DISPLAY | VARCHAR(100) | Y | User-definable display value for the benefits subtype |
| TYPE_DISPLAY | VARCHAR(100) | Y | User-definable display for the benefit type |
| UPDT_APPLCTX | DOUBLE | 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 | DOUBLE | 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 | DATETIME | 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 | DOUBLE | 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 | DOUBLE | 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 - BENEFIT
| Parent Column in BENEFIT (PK) | Child Table Name | Child Column Name | |
|---|---|---|---|
| Children: | BENEFIT_ID | BENEFIT_DETAIL | BENEFIT_ID |
BENEFIT_DETAIL
| Column Section | Relationship Section | Top of Page |
Table-level Detail
| Description: | Defines details for a plan benefit, including quantity and scope of coverage |
| Definition: | Deifnes details for a plan benefit, including quantity and scope of coverage |
| Table Type: | REFERENCE |
Column Detail - BENEFIT_DETAIL
| Column Name | Type | Null? | Definition |
|---|---|---|---|
| ACTIVE_IND | DOUBLE | 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 | DOUBLE | Y | 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 | DATETIME | Y | The date and time that the active_status_cd was set. |
| ACTIVE_STATUS_PRSNL_ID | DOUBLE | Y | The person who caused the active_status_cd to be set or change. |
| BEG_EFFECTIVE_DT_TM | DATETIME | 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. |
| BENEFIT_DETAIL_ID | DOUBLE | N | Unique, system-generated identifier for the benefit detail record. |
| BENEFIT_ID | DOUBLE | N | Foreign key to the benefit which this detail record describes. |
| BNFT_EVENT_CD | DOUBLE | N | Defines the type of event described in the detail record. |
| BNFT_EVENT_QTY | DOUBLE | Y | The number of benefits of this type that will be covered/excluded under the benefits of the plan |
| BNFT_SCOPE_CD | DOUBLE | N | Defines the scope of coverage for the defined benefit event |
| BNFT_SCOPE_VAL | DOUBLE | Y | The value that describes the magnitude of the scope of coverage. |
| END_EFFECTIVE_DT_TM | DATETIME | 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. |
| FT_BNFT_EVENT | VARCHAR(50) | Y | Text field for describing a benefit detail that cannot be defined by codes; must use the "OTHER" meaning in the bnft_event_cd field in conjunction with this field. |
| UPDT_APPLCTX | DOUBLE | N | The application context number from the record info block. |
| UPDT_CNT | DOUBLE | 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 | DATETIME | N | The date and time the row was last inserted or updated. |
| UPDT_ID | DOUBLE | 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 | DOUBLE | N | The registered (assigned) task number for the process that inserted or updated the row. |
Relationship Detail - BENEFIT_DETAIL
| Child Column in BENEFIT_DETAIL(FK) | Parent Table Name | Parent Column Name | |
|---|---|---|---|
| Parents: | BENEFIT_ID | BENEFIT | BENEFIT_ID |
EEM_BENEFIT
| Column Section | Relationship Section | Top of Page |
Table-level Detail
| Description: | EEM Benefit |
| Definition: | EEM Benefits |
| Table Type: | REFERENCE |
Column Detail - EEM_BENEFIT
| Column Name | Type | Null? | Definition |
|---|---|---|---|
| ACTIVE_IND | DOUBLE | 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 | DOUBLE | 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 | DATETIME | Y | The date and time that the active_status_cd was set. |
| ACTIVE_STATUS_PRSNL_ID | DOUBLE | N | The person who caused the active_status_cd to be set or change. |
| BEG_EFFECTIVE_DT_TM | DATETIME | 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_TYPE_CD | DOUBLE | N | Benefit Type Code |
| COST_PER_BED_DAY | DOUBLE | Y | Cost per bed day |
| COST_PER_CASE | DOUBLE | Y | Cost per case |
| DATA_TYPE_CD | DOUBLE | N | A unique identifier for the Data Type Code. |
| DATE_VALUE | DATETIME | Y | Date Value |
| DESCRIPTION | VARCHAR(200) | Y | A long description used for documentation. |
| DOUBLE_VALUE | DOUBLE | N | Double Value |
| EEM_BENEFIT_ID | DOUBLE | N | EEM Benefit Identifier |
| END_EFFECTIVE_DT_TM | DATETIME | 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. |
| INFO_TEXT_ID | DOUBLE | N | Primary Key to LONG_TEXT_REFERENCE table |
| LOCAL_RVU | DOUBLE | Y | Local Relative Value Unit stored against HRG |
| LONG_TEXT_ID | DOUBLE | N | Primary Key to LONG_TEXT_REFERENCE table |
| MNEMONIC | VARCHAR(100) | N | A 100-character string used for identification and selection. |
| MNEMONIC_KEY | VARCHAR(100) | N | The MNEMONIC in uppercase with the non-alphanumeric characters removed. |
| MNEMONIC_KEY_A_NLS | VARCHAR(400) | Y | MNEMONIC_KEY_A_NLS column |
| MNEMONIC_KEY_NLS | VARCHAR(202) | Y | A native sort version of the MNEMONIC_KEY FIELD. |
| NATIONAL_RVU | DOUBLE | Y | National Relative Value Unit stored against HRG |
| NBR_PAT_AGREED | DOUBLE | Y | Number of patients agreed |
| RVU_AMNT | DOUBLE | Y | Relative Value Unit stored against HRG |
| STRING_VALUE | VARCHAR(255) | Y | String Value |
| UNITS_CD | DOUBLE | N | Units Of Measure Code |
| UPDT_APPLCTX | DOUBLE | N | The application context number from the record info block. |
| UPDT_CNT | DOUBLE | 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 | DATETIME | N | The date and time the row was last inserted or updated. |
| UPDT_ID | DOUBLE | 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 | DOUBLE | N | The registered (assigned) task number for the process that inserted or updated the row. |
| VARIANCE_LEVEL | DOUBLE | Y | Variance Level |
Relationship Detail - EEM_BENEFIT
| Child Column in EEM_BENEFIT(FK) | Parent Table Name | Parent Column Name | |
|---|---|---|---|
| Parents: | BENEFIT_TYPE_CD | CODE_VALUE | CODE_VALUE |
| DATA_TYPE_CD | CODE_VALUE | CODE_VALUE | |
| UNITS_CD | CODE_VALUE | CODE_VALUE | |
| INFO_TEXT_ID | LONG_TEXT_REFERENCE | LONG_TEXT_ID | |
| LONG_TEXT_ID | LONG_TEXT_REFERENCE | LONG_TEXT_ID |
| Parent Column in EEM_BENEFIT (PK) | Child Table Name | Child Column Name | |
|---|---|---|---|
| Children: | EEM_BENEFIT_ID | EEM_BENEFIT_ALLOC | EEM_BENEFIT_ID |
| EEM_BENEFIT_QUAL | BENEFIT_ID | ||
| EEM_BENEFIT_RELTN | EEM_BENEFIT_ID |
EEM_BENEFIT_ALLOC
| Column Section | Relationship Section | Top of Page |
Table-level Detail
| Description: | eem benefit allocation |
| Definition: | eem benefit allocation table |
| Table Type: | ACTIVITY |
Column Detail - EEM_BENEFIT_ALLOC
| Column Name | Type | Null? | Definition |
|---|---|---|---|
| ACTIVE_IND | DOUBLE | 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 | DOUBLE | 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 | DATETIME | Y | The date and time that the active_status_cd was set. |
| ACTIVE_STATUS_PRSNL_ID | DOUBLE | N | The person who caused the active_status_cd to be set or change. |
| BEG_EFFECTIVE_DT_TM | DATETIME | 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_ALLOC_ID | DOUBLE | N | unique key to eem_benefit_alloc table |
| EEM_BENEFIT_ID | DOUBLE | N | benefit allocated |
| ENCNTR_ID | DOUBLE | N | encounter identifier value |
| ENCNTR_SLICE_ID | DOUBLE | N | Identifies an Encounter as it relates to a time slice. |
| END_EFFECTIVE_DT_TM | DATETIME | 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. |
| FINALIZED_DT_TM | DATETIME | Y | finalized date and time |
| HEALTH_PLAN_ID | DOUBLE | N | This is the value of the unique primary identifier of the health plan table. It is an internal system assigned number. |
| MADE_BY_ID | DOUBLE | N | made by identifier |
| MAN_ALLOC_REQ_IND | DOUBLE | N | manual allocation request indicator will be set to 1 if the row needs to be manually allocated. |
| NCA_IND | DOUBLE | N | Non-Contracted Activity indicator will be set to 1 if no contract is found or if no benefit qualified for the contract. |
| ORGANIZATION_ID | DOUBLE | N | This is the value of the unique primary identifier of the organization table. It is an internal system assigned number. |
| STATE_CD | DOUBLE | N | state code value |
| SVC_CAT_HIST_ID | DOUBLE | N | service category history identifier column |
| UPDT_APPLCTX | DOUBLE | 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 | DOUBLE | 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 | DATETIME | 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 | DOUBLE | 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 | DOUBLE | 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 - EEM_BENEFIT_ALLOC
| Child Column in EEM_BENEFIT_ALLOC(FK) | Parent Table Name | Parent Column Name | |
|---|---|---|---|
| Parents: | EEM_BENEFIT_ID | EEM_BENEFIT | EEM_BENEFIT_ID |
| ENCNTR_SLICE_ID | ENCNTR_SLICE | ENCNTR_SLICE_ID | |
| ENCNTR_ID | ENCOUNTER | ENCNTR_ID | |
| HEALTH_PLAN_ID | HEALTH_PLAN | HEALTH_PLAN_ID | |
| ORGANIZATION_ID | ORGANIZATION | ORGANIZATION_ID | |
| MADE_BY_ID | PRSNL | PERSON_ID | |
| SVC_CAT_HIST_ID | SERVICE_CATEGORY_HIST | SVC_CAT_HIST_ID |
EEM_BENEFIT_PLAN
| Column Section | Relationship Section | Top of Page |
Table-level Detail
| Description: | EEM Benefit Plan |
| Definition: | Used to store benefit plan information for health plans (and optional sponsor) |
| Table Type: | REFERENCE |
Column Detail - EEM_BENEFIT_PLAN
| Column Name | Type | Null? | Definition |
|---|---|---|---|
| ACTIVE_IND | DOUBLE | 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 | DOUBLE | 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 | DATETIME | Y | The date and time that the active_status_cd was set. |
| ACTIVE_STATUS_PRSNL_ID | DOUBLE | N | The person who caused the active_status_cd to be set or change. |
| BEG_EFFECTIVE_DT_TM | DATETIME | 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_PLAN_CD | DOUBLE | N | Benefit Plan Code |
| BENEFIT_PLAN_ID | DOUBLE | N | Benefit Plan Identifier |
| CONTRACT_CODE | VARCHAR(100) | Y | Contract Code |
| DESCRIPTION | VARCHAR(200) | Y | A long description used for documentation. |
| END_EFFECTIVE_DT_TM | DATETIME | 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. |
| LONG_TEXT_ID | DOUBLE | N | Primary Key to LONG_TEXT_REFERENCE table |
| OPTIONAL_CD | DOUBLE | N | Denotes if the benefit plan is basic or optional coverage |
| PARENT_ENTITY_ID | DOUBLE | N | Primary Key of the Parent Row |
| PARENT_ENTITY_NAME | VARCHAR(30) | Y | Name of the Parent Entity |
| SEQ_NBR | DOUBLE | N | Determines the order among the children of a group. |
| UPDT_APPLCTX | DOUBLE | N | The application context number from the record info block. |
| UPDT_CNT | DOUBLE | 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 | DATETIME | N | The date and time the row was last inserted or updated. |
| UPDT_ID | DOUBLE | 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 | DOUBLE | N | The registered (assigned) task number for the process that inserted or updated the row. |
Relationship Detail - EEM_BENEFIT_PLAN
| Child Column in EEM_BENEFIT_PLAN(FK) | Parent Table Name | Parent Column Name | |
|---|---|---|---|
| Parents: | LONG_TEXT_ID | LONG_TEXT | LONG_TEXT_ID |