Table Detail Report

HP_FINANCIAL



Column Section Relationship Section Top of Page


Table-level Detail

Description: To Be Dropped in Rev 7.9
Definition: Stores financial data for plans, benefits, and procedure benefits for a plan.
Table Type: REFERENCE





Column Detail - HP_FINANCIAL


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 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.
COINSURANCE DOUBLE Y Value of coinsurance amount (percent, i.e. 80 percent)
COPAY DOUBLE Y Value of benefits copay amount (in dollars)
DEDUCTIBLE DOUBLE Y Value of benefit s deductible (in dollars)
END_EFFECTIVE_DT_TM DATETIME Y The date/time after which the row is no longer valid as active current data.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.
HEALTH_PLAN_ID DOUBLE N Foreign key to the health plan to which this financial information belongs.
HP_FINANCIAL_ID DOUBLE N Unique identifier for this health plan financial record.
LIFETIME_MAX_BNFT DOUBLE Y The lifetime maximum benefit (in dollars) for the related benefit or plan.
LOCATION_CD DOUBLE N Stores location, if financial info varies according to location where benefit is received.
MAX_FAM_OUT_POCKET DOUBLE Y Value, in dollars, representing the max amount that the covered family would be required to pay out of pocket for covered benefits.
MAX_OUT_POCKET DOUBLE Y Value, in dollars, representing the max amount that the covered individual would be required to pay out of pocket for covered benefits.
PARENT_ENTITY_ID DOUBLE N Foreign key to the parent entity table record to which this financial record is related.
PARENT_ENTITY_NAME VARCHAR(50) N Name of the parent entity table, to which this financial record is related.
REMARKS VARCHAR(200) Y Remarks
SPECIALTY_CD DOUBLE N Used to store the specialty_cd value if this financial record is related to a specialty type benefit.
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 - HP_FINANCIAL


Child Column in HP_FINANCIAL(FK) Parent Table Name Parent Column Name
Parents: HEALTH_PLAN_ID HEALTH_PLAN HEALTH_PLAN_ID
LOCATION_CD LOCATION LOCATION_CD


NETWORK



Column Section Relationship Section Top of Page


Table-level Detail

Description: Health Plan Provider Network
Definition: Stores data for a health plan's network(s) of providers. This table stores the network's basic information such as name and effective and expiration dates.
Table Type: REFERENCE





Column Detail - NETWORK


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 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.
CARRIER_ID DOUBLE N CARRIER_ID is the foreign key to an ORGANIZATION record that identifies the ORGANIZATION of type 'INSCO' (stored in the org_type_reltn table) that owns/contracts the provider network identified by the record.
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.
NETWORK_DESCRIPTION VARCHAR(200) Y Stores a more complete description of the health plan provider network referenced in a record.
NETWORK_ID DOUBLE N Network Identifier - this is the unique, Oracle-generated key for the network record.
NETWORK_NAME VARCHAR(100) N NETWORK_NAME stores a text string that defines the name of a health plan provider network. The name must be unique.
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 - NETWORK


Child Column in NETWORK(FK) Parent Table Name Parent Column Name
Parents: CARRIER_ID ORGANIZATION ORGANIZATION_ID




Parent Column in NETWORK (PK) Child Table Name Child Column Name
Children: NETWORK_ID ORG_NTWK_PRVDR NETWORK_ID


NTWK_PRSNL_GROUP_RELTN



Column Section Top of Page


Table-level Detail

Description: NTWK PRSNL GROUP RELTN
Definition: stores a relationship between networks and prsnl groups
Table Type: REFERENCE





Column Detail - NTWK_PRSNL_GROUP_RELTN


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.
DATA_STATUS_CD DOUBLE N Data status indicates a level of authenticity of the row data. Typically this will either be AUTHENTICATED or UNAUTHENTICATED.
DATA_STATUS_DT_TM DATETIME Y The date and time that the data_status_cd was set.
DATA_STATUS_PRSNL_ID DOUBLE N The person who caused the data_status_cd to be set or change.
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.
NETWORK_ID DOUBLE N Unique identifier of the Network table
NTWK_PRSNL_GROUP_RELTN_ID DOUBLE N unique identifier for the ntwk_prsnl_group_reltn table
NTWK_SPCLTY_RELTN_ID DOUBLE N unique identifier of the ntwk_spclty_reltn table
PRSNL_GROUP_ID DOUBLE N unique identifier of the prsnl_group table
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.


NTWK_SPCLTY_RELTN



Column Section Top of Page


Table-level Detail

Description: NTWK SPCLTY RELTN
Definition: Makes one to many relationship between a network and specialties.
Table Type: REFERENCE





Column Detail - NTWK_SPCLTY_RELTN


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.
DATA_STATUS_CD DOUBLE N Data status indicates a level of authenticity of the row data. Typically this will either be AUTHENTICATED or UNAUTHENTICATED.
DATA_STATUS_DT_TM DATETIME Y The date and time that the data_status_cd was set.
DATA_STATUS_PRSNL_ID DOUBLE N The person who caused the data_status_cd to be set or change.
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.
NETWORK_ID DOUBLE N unique identifier for the network table
NTWK_SPCLTY_RELTN_ID DOUBLE N Unique Identifier for the ntwk_spclty_reltn table
SPECIALTY_CD DOUBLE N Code value that describes a person_provider's specialty within a specified provider
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.


ORG_NTWK_PRVDR



Column Section Relationship Section Top of Page


Table-level Detail

Description: Health Plan Network Providers that are of type "Organization"
Definition: This table stores organizations that are health care providers for a given provider network. It stores begin and end effective dates, and specialty codes for the provider as well.
Table Type: ACTIVITY





Column Detail - ORG_NTWK_PRVDR


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 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.
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.
NETWORK_ID DOUBLE Y Pointer to a record in the NETWORK table for which this org provider applies
ORGANIZATION_ID DOUBLE N Stores a pointer to an organization record in the ORGANIZATION table
ORG_NTWK_PRVDR_ID DOUBLE N Unique, ORACLE-generated primary key for the record
SPECIALTY_CD DOUBLE Y Describes a provider's specialty in the health care process, such as cardiologist, home health, hospital, etc.
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 - ORG_NTWK_PRVDR


Child Column in ORG_NTWK_PRVDR(FK) Parent Table Name Parent Column Name
Parents: NETWORK_ID NETWORK NETWORK_ID
ORGANIZATION_ID ORGANIZATION ORGANIZATION_ID