Overview Top Package Entity

Atomic Warehouse Model Data Model

---

Entity Encounter / Coverage Eligibility

Description

An association between an encounter and a coverage eligibility.

Attributes

Authorization Dt

Authorization Num

Billing Status Code Sk

Charge Suspend Ind

Copay Limit Reached Ind

Coverage Eligibility Sk

Effective From Dt

Effective To Dt

Encounter Sk

Insurance Verification Status Descr

Insured Relation To Patient Code Sk

Insured Relation To Patient End Dt

Insured Relation To Patient Start Dt

Load Info Sk

Notice Of Admission Date Ts

Patient Relation To Insured Code Sk

Relationship Type Code Sk

Report Of Eligibility Date Ts

Signature Code Sk

Signature Date Ts

Source Code Sk

Stoploss Limit Reached Ind

Tenant Sk

Valid From Ts

Valid To Ts

Verification Date Time

Verified By Sk

Relationship

Encounter / Provider Patient Insurance Rlshp_Provider Patient Insurance_FK

Encounter / Provider Patient Insurance Rlshp_Encounter_FK

Encounter / Provider Patient Insurance Rlshp_Name_FK

Primary Key

Encounter / Coverage Eligibility PK

Dependencies

Reverse Dependencies

Attribute Details

 Authorization Dt

Description	The date upon which the insurer issued authorization for patient eligibility.
Data Type	Standards - Data Domains.ddm/Data Domains/Date [DATE]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

---

 Authorization Num

Description	An insurer issued authorization number or code usually obtained prior to all non-emergency admissions and within 48 hours of an emergency admission.
Data Type	Standards - Data Domains.ddm/Data Domains/String [VARCHAR(255)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

---

 Billing Status Code Sk

Description	Indicates the status of the insurance billing.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

---

 Charge Suspend Ind

Description	Indicates whether or not charges should be suspended for a patient
Data Type	Standards - Data Domains.ddm/Data Domains/Boolean Indicator [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

---

 Copay Limit Reached Ind

Description	Indicates whether or not the patient has reached the co-pay limit.
Data Type	Standards - Data Domains.ddm/Data Domains/Boolean Indicator [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

---

 Coverage Eligibility Sk

Description	The anchor surrogate key for the Provider Patient Insurance data.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKey	true
Is Required	true
Is Derived	false
Is Surrogate Key	false

---

 Effective From Dt

Description	Establishes a period where a set of attributes are true according to the business.
Data Type	Standards - Data Domains.ddm/Data Domains/Date [DATE]
Is Part Of PrimaryKey	false
Is Required	true
Is Derived	false
Is Surrogate Key	false

---

 Effective To Dt

Description	Ends a period of effectivity.
Data Type	Standards - Data Domains.ddm/Data Domains/Date [DATE]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

---

 Encounter Sk

Description	Anchor surrogate key for the Encounter data.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKey	true
Is Required	true
Is Derived	false
Is Surrogate Key	false

---

 Insurance Verification Status Descr

Description	The status of this patient's relationship with this insurance carrier.
Data Type	Standards - Data Domains.ddm/Data Domains/String [VARCHAR(255)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

---

 Insured Relation To Patient Code Sk

Description	Indicates the insured's relationship to the patient.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

---

 Insured Relation To Patient End Dt

Description	The date after which the insured's relationship to the patient is no longer effective.
Data Type	Standards - Data Domains.ddm/Data Domains/Date [DATE]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

---

 Insured Relation To Patient Start Dt

Description	The date upon which the insured's relationship to the patient began. For example: Parent (insurer) and child (patient)
Data Type	Standards - Data Domains.ddm/Data Domains/Date [DATE]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

---

 Load Info Sk

Description	The surrogate key of the load information entry describing the details regarding the loading of the row.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKey	false
Is Required	true
Is Derived	false
Is Surrogate Key	false

---

 Notice Of Admission Date Ts

Description	The date and time that a notice of admission was sent.
Data Type	Standards - Data Domains.ddm/Data Domains/Timestamp [TIMESTAMP]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

---

 Patient Relation To Insured Code Sk

Description	The relationship of the patient to the insured. For example: Patient is insured  Spouse  Natural child/insured financial responsibility  Natural child/Insured does not have financial responsibility  Step child  Foster child  Ward of the court  Employee  Unknown  Handicapped dependent  Organ donor  Cadaver donor  Grandchild  Niece/nephew  Injured plaintiff  Sponsored dependent  Minor dependent of a minor dependent  Parent  Grandparent
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

---

 Relationship Type Code Sk

Description	Identifies the type of the relationship as defined in the business data model.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER]
Is Part Of PrimaryKey	true
Is Required	true
Is Derived	false
Is Surrogate Key	false

---

 Report Of Eligibility Date Ts

Description	The date and time that a Report of Eligibility (ROE) was received
Data Type	Standards - Data Domains.ddm/Data Domains/Timestamp [TIMESTAMP]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

---

 Signature Code Sk

Description	Indicates how the patient/subscriber authorization signature was obtained and how it is being retained by the provider.  For example: Signed CMS-1500 claim form on file Signed authorization for release of any medical or other information necessary to process this claim on file.  Signed authorization for assignment of benefits on file.  Signature generated by provider because the patient was not physically present for services.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

---

 Signature Date Ts

Description	The date and time that the patient/subscriber authorization signature was obtained.
Data Type	Standards - Data Domains.ddm/Data Domains/Timestamp [TIMESTAMP]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

---

 Source Code Sk

Description	The origin of the data identifying the actual load source, vendor, manual key entry, or context of the data in a specific row in the database.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER]
Is Part Of PrimaryKey	false
Is Required	true
Is Derived	false
Is Surrogate Key	false

---

 Stoploss Limit Reached Ind

Description	Indicates whether or not the patient has reached the stop loss limit established in the Contract Master.
Data Type	Standards - Data Domains.ddm/Data Domains/Boolean Indicator [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

---

 Tenant Sk

Description	The surrogate key of the entry identifying the legal owner of the data.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER]
Is Part Of PrimaryKey	false
Is Required	true
Is Derived	false
Is Surrogate Key	false

---

 Valid From Ts

Description	Establishes a period where a set of attributes are true in the source system. This would be populated with the transaction timestamp and would be used for the snapshot date.
Data Type	Standards - Data Domains.ddm/Data Domains/Timestamp [TIMESTAMP]
Is Part Of PrimaryKey	true
Is Required	true
Is Derived	false
Is Surrogate Key	false

---

 Valid To Ts

Description	Ends a period of validity.
Data Type	Standards - Data Domains.ddm/Data Domains/Timestamp [TIMESTAMP]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

---

 Verification Date Time

Description	The date and time that the healthcare provider verified that the patient has the indicated benefits.
Data Type	Standards - Data Domains.ddm/Data Domains/Timestamp [TIMESTAMP]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

---

 Verified By Sk

Description	Anchor surrogate key for the Party Name data
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Relationship Details

 Encounter / Provider Patient Insurance Rlshp_Provider Patient Insurance_FK

Is Identifying Relationship	true
Child Table	Encounter / Coverage Eligibility
Child Multiplicity	ZERO_TO_MANY
Child Referential Integrity: On Delete	NONE
Child Referential Integrity: On Insert	NONE
Child Referential Integrity: On Update	NONE
Parent Table	Coverage Eligibility
Parent Multiplicity	ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

---

 Encounter / Provider Patient Insurance Rlshp_Encounter_FK

Is Identifying Relationship	true
Child Table	Encounter / Coverage Eligibility
Child Multiplicity	ZERO_TO_MANY
Child Referential Integrity: On Delete	NONE
Child Referential Integrity: On Insert	NONE
Child Referential Integrity: On Update	NONE
Parent Table	Encounter
Parent Multiplicity	ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

---

 Encounter / Provider Patient Insurance Rlshp_Name_FK

Is Identifying Relationship	false
Child Table	Encounter / Coverage Eligibility
Child Role Name	verified by
Child Multiplicity	ZERO_TO_MANY
Child Referential Integrity: On Delete	NONE
Child Referential Integrity: On Insert	NONE
Child Referential Integrity: On Update	NONE
Parent Table	Name
Parent Multiplicity	ZERO_TO_ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

Primary Key Details

 Encounter / Coverage Eligibility PK

Key Attribute	Coverage Eligibility Sk
Key Attribute	Encounter Sk
Key Attribute	Relationship Type Code Sk
Key Attribute	Valid From Ts

---

Overview Top Package Entity

Atomic Warehouse Model Data Model