Table Detail Report

PROCEDURE_CODE_TIER



Column Section Relationship Section Top of Page


Table-level Detail

Description: PROCEDURE CODE TIER
Definition: Stores "rules" to define relationships between CPT-4, HCPCS, and revenue codes.
Table Type: REFERENCE





Column Detail - PROCEDURE_CODE_TIER


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.
ACTIVITY_TYPE_CD DOUBLE N Activity type
BEGIN_CPT4 VARCHAR(200) Y The beginning cpt4 value for range
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.
BILLING_ENTITY_ID DOUBLE N Reference to the billing entity
BILL_ITEM_ID DOUBLE N Bill_item_id that the charge was ordered from
ENCNTR_TYPE_CD DOUBLE N Encounter type from code_set 71
END_CPT4 VARCHAR(200) Y The ending cpt4 value for range
END_EFFECTIVE_DT_TM DATETIME N The date/time after which the row is no longer valid as active current data.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.
HCPCS VARCHAR(200) Y The HCPCS value (source_code from nomenclature)
HEALTH_PLAN_ID DOUBLE N Reference to Health_plan table
PROCEDURE_CODE_TIER_ID DOUBLE N Primary key into procedure_code tier using new sequence pft_procedure_code_tier_seq
ROW_NUM DOUBLE N This stores the row number of where they belong in the spreadsheet
SERVICE_RESOURCE_CD DOUBLE N Service resource from code set 220
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 - PROCEDURE_CODE_TIER


Child Column in PROCEDURE_CODE_TIER(FK) Parent Table Name Parent Column Name
Parents: BILLING_ENTITY_ID BILLING_ENTITY BILLING_ENTITY_ID
HEALTH_PLAN_ID HEALTH_PLAN HEALTH_PLAN_ID




Parent Column in PROCEDURE_CODE_TIER (PK) Child Table Name Child Column Name
Children: PROCEDURE_CODE_TIER_ID TIER_REV_CODE_RELTN PROCEDURE_CODE_TIER_ID


REV_CODE_EXCEPTION



Column Section Relationship Section Top of Page


Table-level Detail

Description: REV CODE EXCEPTION
Definition: Revenue Code Exception
Table Type: REFERENCE





Column Detail - REV_CODE_EXCEPTION


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.
BILL_TYPE_CD DOUBLE N This is the bill type such as HCFA 1450, Patient Stmt, or Client Invoice
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 Health Plan ID
NOMENCLATURE_ID DOUBLE N Nomenclature ID
REVENUE_CD DOUBLE N Revenue CD
REV_CODE_EXCEPTION_ID DOUBLE N Revenue Code Exception ID
REV_CODE_FLAG DOUBLE N Provides functionality for Claim Rollup functionality - Flag will determine Degree of Claim Rollup on a Revenue code by Revenue code basis. Flag Values - Default is 0 (Normal rollup processing), 1 (Skip Rollup Processing).
SOURCE_VOCAB_CD DOUBLE N Source Vocabulary Cd
UB_BILL_CLASS_CD DOUBLE N UB Bill Class Code
UB_BILL_FREQ_CD DOUBLE N UB Bill Frequency CD
UB_FACILITY_TYPE_CD DOUBLE N UB Facility Type CD
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 - REV_CODE_EXCEPTION


Child Column in REV_CODE_EXCEPTION(FK) Parent Table Name Parent Column Name
Parents: HEALTH_PLAN_ID HEALTH_PLAN HEALTH_PLAN_ID


STATEMENT_CYCLE



Column Section Relationship Section Top of Page


Table-level Detail

Description: Stores the information related to a statement cycle.
Definition: Stores the information related to a Statement Cycle.
Table Type: REFERENCE





Column Detail - STATEMENT_CYCLE


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.
BILLING_ENTITY_ID DOUBLE N Foreign key reference to the billing_entity table.
BILL_CLASS_CD DOUBLE N Bill Class
BILL_SEQ DOUBLE N The sequence in which the schedule is done.
CYCLE DOUBLE N Then number of days between bills.
CYCLE_NAME VARCHAR(100) Y descriptive name of the cycle
DUNNING_LEVEL_CD DOUBLE N Code value indicating collections state that a ProFit encounter is in (e.g. normal, collections etc.).
DUNNING_LEVEL_CNT DOUBLE N Indicates how many times a bill has been sent at the current dunning level code.
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.
EXT_BILLING_IND DOUBLE N Indicates if the ProFit encounter needs to be send to the outside collection agency at the given dunning level.
MONTHLY_IND DOUBLE N Indicator that determines whether the statement will be generated on the same day every month.
STATEMENT_CYCLE_CD DOUBLE N Statement Cycle Code
STATEMENT_CYCLE_ID DOUBLE N Primary Key
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 - STATEMENT_CYCLE


Child Column in STATEMENT_CYCLE(FK) Parent Table Name Parent Column Name
Parents: BILLING_ENTITY_ID BILLING_ENTITY BILLING_ENTITY_ID




Parent Column in STATEMENT_CYCLE (PK) Child Table Name Child Column Name
Children: STATEMENT_CYCLE_ID CBOS_PE_RELTN STATEMENT_CYCLE_ID
PFT_ENCNTR STATEMENT_CYCLE_ID
STATEMENT_CYCLE_RELTN NEXT_CYCLE_ID
STATEMENT_CYCLE_RELTN STATEMENT_CYCLE_ID
STMT_CYCLE_CHILD_RELTN STATEMENT_CYCLE_ID


STATEMENT_CYCLE_RELTN



Column Section Relationship Section Top of Page


Table-level Detail

Description: STATEMENT CYCLE RELTN
Definition: Stores bulk of data related to Statement_Cycles
Table Type: REFERENCE





Column Detail - STATEMENT_CYCLE_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.
BAD_DEBT_IND DOUBLE Y Indicates if this encounter is in bad debt.
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.
DEFAULT_IND DOUBLE Y Indicates that an initial statement cycle rule is the default rule. A default statement cycle rule will always qualify if no other (non-default) rules qualify.
DENIAL_CD DOUBLE N Denial Code related to this statement Cycle.
DENIAL_GROUP_CD DOUBLE N Denial Group Code related to this statement Cycle
ENCNTR_STATUS_CD DOUBLE N Status of the financial encounter.
ENCNTR_VIP_IND DOUBLE Y Indicates if this encounter is for a VIP
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.
EXCLUDE_FACILITY_ORG_ID DOUBLE N The organization that is excluded for a statement cycle
FIN_CLASS_CD DOUBLE N Financial class code value
FORMAL_PAY_PLAN_IND DOUBLE Y Indicates if encounter is on a formal payment plan
FPP_AUTOMATED_PAYMENT_IND DOUBLE N Indicator to determine if the formal payment plan has automated payments on it.
HEALTH_PLAN_ID DOUBLE N FK to Health Plan table
INFORMAL_PAY_PLAN_IND DOUBLE Y Indicates if encntr is on an informal payment plan
INSURANCE_ORG_ID DOUBLE N Selected insurance organization for given statement cycle. Foreign key to the Organization table
NEXT_CYCLE_ID DOUBLE N FK back to statement cycle table for the next cycle in seqence
PARENT_ENTITY_ID DOUBLE N Billing Entity or PFT_encntr
PARENT_ENTITY_NAME VARCHAR(40) Y BILLING_ENTITY or PFT_ENCNTR
PERSON_VIP_IND DOUBLE Y Indicates if person is a VIP
PRIMARY_CYCLE_IND DOUBLE Y Indicates if this statement cycle is the primary cycle
PROCESS_PRIORITY_NBR DOUBLE Y A value that indicates the order in which the statement cycles should be processed. The highest priority item gets a process_priority_nbr of 1.
START_FLAG DOUBLE Y Stores when to start the cycle0 - Discharged, 1 - Selfpay Ready To Bill, 2 - Primary Insurance Billed,3 - Primary Insurance Transmitted,4 - Secondary Insurance Billed,5 - Secondary Insurance Transmitted
STATEMENT_CYCLE_ID DOUBLE N Foreign key to the Statement cycle table
STATEMENT_CYCLE_RELTN_ID DOUBLE N Primary Key
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 - STATEMENT_CYCLE_RELTN


Child Column in STATEMENT_CYCLE_RELTN(FK) Parent Table Name Parent Column Name
Parents: HEALTH_PLAN_ID HEALTH_PLAN HEALTH_PLAN_ID
EXCLUDE_FACILITY_ORG_ID ORGANIZATION ORGANIZATION_ID
INSURANCE_ORG_ID ORGANIZATION ORGANIZATION_ID
NEXT_CYCLE_ID STATEMENT_CYCLE STATEMENT_CYCLE_ID
STATEMENT_CYCLE_ID STATEMENT_CYCLE STATEMENT_CYCLE_ID


STMT_CYCLE_CHILD_RELTN



Column Section Relationship Section Top of Page


Table-level Detail

Description: STMT CYCLE CHILD RELTN
Definition: Stores the next cycle information for each of the payment received options
Table Type: REFERENCE





Column Detail - STMT_CYCLE_CHILD_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 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.
CHILD_CYCLE_PAYMENT_CD DOUBLE N Type of child relationship row. One of the payment levels from code set 26941
DUNNING_LEVEL_CNT DOUBLE N Indicates how many times to bill at this level for this payment type before moving to the next cycle
END_EFFECTIVE_DT_TM DATETIME 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.
NEXT_CYCLE_ID DOUBLE N Will reference the next cycle in the defined path, cycle id is on the statement cycle table
STATEMENT_CYCLE_ID DOUBLE N Foreign key to the statement_cycle table
STATEMENT_CYCLE_RELTN_ID DOUBLE N no longer used
STMT_CYCLE_CHILD_RELTN_ID DOUBLE N Unique identifier to this 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.



Relationship Detail - STMT_CYCLE_CHILD_RELTN


Child Column in STMT_CYCLE_CHILD_RELTN(FK) Parent Table Name Parent Column Name
Parents: STATEMENT_CYCLE_ID STATEMENT_CYCLE STATEMENT_CYCLE_ID