The claims table manages all claim records for the specified patient.
| Name |
Type
|
Description |
| id |
VARCHAR |
Surrogate key. Primary key for the claims table.
|
| identifier |
VARCHAR |
The primary external identifier (provided by the source system) to identify this claim instance.
|
| mrn |
VARCHAR |
Medical records number of the related patient, if available.
|
| startdate |
VARCHAR |
The start date for the claim.
|
| enddate |
VARCHAR |
The end date for the claim.
|
| totalcharges |
NUMERIC |
A sum of all charges represented by this claim instance.
|
| totalpaid |
NUMERIC |
The total amount paid for this claim instance.
|
| comment |
VARCHAR |
Notes/comments entered regarding this claim
|
| paiddate |
VARCHAR |
The date the claim was paid.
|
| controlnumber |
VARCHAR |
The provider’s Encounter/Visit number for this clinical encounter.
|
| admitdate |
VARCHAR |
If applicable, the admit date of the hospitalization or bedded stay associated with this claim instance.
|
| dischargedate |
VARCHAR |
If applicable, the discharge date of the hospitalization or bedded stay associated with this claim instance.
|
| adjudicationdate |
VARCHAR |
Date the insurer determined the payment status of this claim
|
| totalpatientpaid |
NUMERIC |
The total amount paid for this claim instance by the patient.
|
| admittypeterm_id |
INTEGER |
Surrogate key. Foreign key reference to terms.id
|
| statusterm_id |
INTEGER |
Surrogate key. Foreign key reference to terms.id. Indicates concepts such as- pending, final, canceled, etc.
|
| billclassterm_id |
INTEGER |
Surrogate key. Foreign key reference to terms.id
|
| patient_id |
VARCHAR |
Surrogate key. Foreign key reference to patients.id
|
| encounter_id |
VARCHAR |
Surrogate key. Foreign key reference to encounters.id
|
| insurance_id |
VARCHAR |
Surrogate key. Foreign key reference to insurances.id
|
| referral_id |
VARCHAR |
Surrogate key. Foreign key reference to referrals.id
|
| claimtypeterm_id |
INTEGER |
Surrogate key. Foreign key reference to terms.id. High level category of the claim, common values- Medical/Dental/Vision/Transportation
|
| facilitytypeterm_id |
INTEGER |
Surrogate key. Foreign key reference to terms.id
|
| admitsourceterm_id |
INTEGER |
Surrogate key. Foreign key reference to terms.id
|
| patientstatusterm_id |
INTEGER |
Surrogate key. Foreign key reference to terms.id
|
| nonpaymentreasonterm_id |
INTEGER |
Surrogate key. Foreign key reference to terms.id
|
| datasource_id |
VARCHAR |
Surrogate key. Foreign key reference to datasources.id. The external data source from which the data in this row originated.
|
| inserteddate |
TIMESTAMP |
Timestamp (UTC) indicating the date the row was first inserted into HIEBus.
|
| insertedbyapplication_id |
SMALLINT |
The application that first inserted the row into HIEBus. Foreign key reference to applications.id.
|
| insertedbyuser_id |
VARCHAR |
The user associated with the process that first inserted the row into HIEBus. Foreign key reference to users.id.
|
| modifieddate |
TIMESTAMP |
Timestamp (UTC) indicating the date the row was last modified.
|
| modifiedbyapplication_id |
SMALLINT |
The application that last modified the row. Foreign key reference to applications.id.
|
| modifiedbyuser_id |
VARCHAR |
The user associated with the process that last modified the row. Foreign key reference to users.id.
|
| alternateidentifier |
VARCHAR |
A secondary external identifier (provided by the source system) to identify this claim instance.
|
| drgterm_id |
INTEGER |
Surrogate key. Foreign key reference to terms.id
|
| dispositionterm_id |
INTEGER |
Surrogate key. Foreign key reference to terms.id
|
| tenant_id |
SMALLINT |
Surrogate key. Foreign key reference to tenants.id
|
| createddate |
VARCHAR |
The date that the originating party created this claim instance.
|
| totalallowed |
NUMERIC |
Payment information for this claim instance.
|
| totalcoinsuranceamount |
NUMERIC |
Payment information for this claim instance.
|
| totaldeductibleamount |
NUMERIC |
Payment information for this claim instance.
|
| totalcopayamount |
NUMERIC |
Payment information for this claim instance.
|
| totalnotcoveredamount |
NUMERIC |
Payment information for this claim instance.
|
| insuranceidentifier |
VARCHAR |
The insurance identifier used by the patient related to this claim.
|
| authorizationnumber |
VARCHAR |
An authorization number provided by the claim payer for this claim.
|
| totalhsapaidamount |
NUMERIC |
Payment information for this claim instance.
|
| totalpatientresponsibleamount |
NUMERIC |
Payment information for this claim instance.
|
| revision |
INTEGER |
Indicates the latest claim version number as it’s updated though adjustments, available only when reported by source
|
| innetworkterm_id |
INTEGER |
Surrogate key. Foreign key reference to terms.id
|
