Atomic Warehouse Model Data Model

Entity

Entity Coordination Of Benefits Detail

Description

A method that is used by a health plan organization to ensure that the total amount paid is not greater than the expenses incurred when a member is covered by more than one policy. The order of liability for each policy is determined by the coverage precedence. Coordination of benefits (COB) applies, for example, to a family where both spouses have group coverage through their employers or to an individual who has Medicare and an individual insurance policy.

Attributes
Actual End Dt
Actual Labor Hours
Actual Start Dt
Actual Time Spent
Claim Coverage Precedence Alteration Dt
Coordination Of Benefits Reason Code Sk
Coordination Of Benefits Sk
Coverage Precedence Alteration Reason Code Sk
Delay Reason Code Sk
Effective From Dt
Effective To Dt
Load Info Sk
Name
Other Carrier Claim Adjusted Ind
Other Carrier Health Plan Product Code Sk
Other Coverage Precedence Type Code Sk
Our Coverage Precedence Type Code Sk
Planned Duration
Planned End Dt
Planned Manpower
Planned Start Dt
Source Code Sk
Tenant Sk
Type Code Sk
Valid From Ts
Valid To Ts

Relationship
Coordination Of Benefits Detail_Coordination Of Benefits_FK

Primary Key
Coordination Of Benefits Detail PK

Dependencies

Reverse Dependencies

Attribute Details

Actual End Dt

Description	Actual date upon which the activity was ended.
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

Actual Labor Hours

Description	Actual number hours that it took to perform the activity.
Data Type	Standards - Data Domains.ddm/Data Domains/Small Counter [SHORT]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Actual Start Dt

Description	Actual date upon which the activity was started.
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

Actual Time Spent

Description	The actual time spent performing the activity. This differs from the labor hours by describing the elapsed time over which the labor hours were spread. For example, an activity may involve 4 hours actual work over 3 days.
Data Type	Standards - Data Domains.ddm/Data Domains/Number Decimal Large [DECIMAL(15,6)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Claim Coverage Precedence Alteration Dt

Description	The date upon which the change to coverage precedence was actually made, which may or may not be the date from which it becomes 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

Coordination Of Benefits Reason Code Sk

Description	Indicates why the member has multiple coverage.
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

Coordination Of Benefits Sk

Description	Surrogate key for the anchor entity.
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

Coverage Precedence Alteration Reason Code Sk

Description	Indicates why a change in coverage precedence may be made.
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

Delay Reason Code Sk

Description	Indicates the cause of any discrepancy between planned and actual end dates.
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

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

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

Name

Description	A word or phrase identifying the activity.
Data Type	Standards - Data Domains.ddm/Data Domains/Name [VARCHAR(30)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Other Carrier Claim Adjusted Ind

Description	Indicates that the other payer had previously paid this claim and then has re-adjudicated the claim and is sending the adjusted payment information. Therefore this claim is an adjustment of a previously adjudicated claim. 1 Yes 0 No
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

Other Carrier Health Plan Product Code Sk

Description	The health benefits plan or other insurance plan of the other carrier.
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

Other Coverage Precedence Type Code Sk

Description	indicates the precedence type of health plan organizations other than the modeled organization.
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

Our Coverage Precedence Type Code Sk

Description	Indicates the precedence type of the modeled health plan organization.
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

Planned Duration

Description	The time planned for the performing of the activity. This is the total elapsed time over which the activity is expected to be performed and not the planned labor hours.
Data Type	Standards - Data Domains.ddm/Data Domains/Number Decimal Large [DECIMAL(15,6)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Planned End Dt

Description	Date upon which the activity is planned to end.
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

Planned Manpower

Description	The planned labor hours required for the activity.
Data Type	Standards - Data Domains.ddm/Data Domains/Number Decimal Large [DECIMAL(15,6)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Planned Start Dt

Description	Date upon which the activity is planned to start.
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

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

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

Type Code Sk

Description	Identifies the actual type of the entry based on the entity type hierarchy defined in the business data model.
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

Relationship Details

Coordination Of Benefits Detail_Coordination Of Benefits_FK

Is Identifying Relationship	true
Child Table	Coordination Of Benefits Detail
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	Coordination Of Benefits
Parent Multiplicity	ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

Primary Key Details

Coordination Of Benefits Detail PK

Key Attribute	Coordination Of Benefits Sk
Key Attribute	Valid From Ts

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Atomic Warehouse Model Data Model