Entity Explanation Of Benefits

DescriptionAn association between a claim line, a claim adjustment, a patient financial transaction, a patient, a plan member, a practitioner, and a communication. An explanation of benefits (EOB) is a communication issued to a member explaining the adjudication of benefits with respect to a submitted claim.

Attributes
Claim Adjustment SkClaim Adjustment Sk
Claim Line SkClaim Line Sk
Communication SkCommunication Sk
Effective From DtEffective From Dt
Effective To DtEffective To Dt
Load Info SkLoad Info Sk
Patient Financial Transaction SkPatient Financial Transaction Sk
Patient SkPatient Sk
Plan Member SkPlan Member Sk
Practitioner SkPractitioner Sk
Relationship Type Code SkRelationship Type Code Sk
Source Code SkSource Code Sk
Tenant SkTenant Sk
Valid From TsValid From Ts
Valid To TsValid To Ts

Relationship
Explanation Of Benefit_Claim Line_FKExplanation Of Benefit_Claim Line_FK
Explanation Of Benefit_Claim Adjustment_FKExplanation Of Benefit_Claim Adjustment_FK
Explanation Of Benefit_Patient Financial Transaction_FKExplanation Of Benefit_Patient Financial Transaction_FK
Explanation Of Benefit_Patient_FKExplanation Of Benefit_Patient_FK
Explanation Of Benefit_Plan Member_FKExplanation Of Benefit_Plan Member_FK
Explanation Of Benefit_Practitioner_FKExplanation Of Benefit_Practitioner_FK
Explanation Of Benefits_Communication_FKExplanation Of Benefits_Communication_FK

Primary Key
Explanation Of Benefits PKExplanation Of Benefits PK

Dependencies
 

Reverse Dependencies
 

Attribute Details

 Claim Adjustment Sk
DescriptionSurrogate key for the anchor entity.
Data TypeStandards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKeytrue
Is Requiredtrue
Is Derivedfalse
Is Surrogate Keyfalse



 Claim Line Sk
DescriptionSurrogate key for the anchor entity.
Data TypeStandards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKeytrue
Is Requiredtrue
Is Derivedfalse
Is Surrogate Keyfalse



 Communication Sk
DescriptionAnchor surrogate key for the Communication data
Data TypeStandards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKeytrue
Is Requiredtrue
Is Derivedfalse
Is Surrogate Keyfalse



 Effective From Dt
DescriptionEstablishes a period where a set of attributes are true according to the business.
Data TypeStandards - Data Domains.ddm/Data Domains/Date [DATE]
Is Part Of PrimaryKeyfalse
Is Requiredtrue
Is Derivedfalse
Is Surrogate Keyfalse



 Effective To Dt
DescriptionEnds a period of effectivity.
Data TypeStandards - Data Domains.ddm/Data Domains/Date [DATE]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse



 Load Info Sk
DescriptionThe surrogate key of the load information entry describing the details regarding the loading of the row.
Data TypeStandards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKeyfalse
Is Requiredtrue
Is Derivedfalse
Is Surrogate Keyfalse



 Patient Financial Transaction Sk
DescriptionSurrogate key for Anchor entity.
Data TypeStandards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKeytrue
Is Requiredtrue
Is Derivedfalse
Is Surrogate Keyfalse



 Patient Sk
DescriptionAnchor surrogate key for the Patient data.
Data TypeStandards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKeytrue
Is Requiredtrue
Is Derivedfalse
Is Surrogate Keyfalse



 Plan Member Sk
DescriptionSurrogate key for Anchor entity.
Data TypeStandards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKeytrue
Is Requiredtrue
Is Derivedfalse
Is Surrogate Keyfalse



 Practitioner Sk
DescriptionThe ID assigned to uniquely identify all staff associated with provider, research, clinical care and associated users of the system.
Data TypeStandards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKeytrue
Is Requiredtrue
Is Derivedfalse
Is Surrogate Keyfalse



 Relationship Type Code Sk
DescriptionIdentifies the type of the relationship as defined in the business data model.
Data TypeStandards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER]
Is Part Of PrimaryKeytrue
Is Requiredtrue
Is Derivedfalse
Is Surrogate Keyfalse



 Source Code Sk
DescriptionThe 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 TypeStandards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER]
Is Part Of PrimaryKeyfalse
Is Requiredtrue
Is Derivedfalse
Is Surrogate Keyfalse



 Tenant Sk
DescriptionThe surrogate key of the entry identifying the legal owner of the data.
Data TypeStandards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER]
Is Part Of PrimaryKeyfalse
Is Requiredtrue
Is Derivedfalse
Is Surrogate Keyfalse



 Valid From Ts
DescriptionEstablishes 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 TypeStandards - Data Domains.ddm/Data Domains/Timestamp [TIMESTAMP]
Is Part Of PrimaryKeytrue
Is Requiredtrue
Is Derivedfalse
Is Surrogate Keyfalse



 Valid To Ts
DescriptionEnds a period of validity.
Data TypeStandards - Data Domains.ddm/Data Domains/Timestamp [TIMESTAMP]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse

Relationship Details

 Explanation Of Benefit_Claim Line_FK
Is Identifying Relationshiptrue
Child TableExplanation Of Benefits
Child MultiplicityZERO_TO_MANY
Child Referential Integrity: On DeleteNONE
Child Referential Integrity: On InsertNONE
Child Referential Integrity: On UpdateNONE
Parent TableClaim Line
Parent MultiplicityONE
Parent Referential Integrity: On DeleteNONE
Parent Referential Integrity: On InsertNONE
Parent Referential Integrity: On UpdateNONE



 Explanation Of Benefit_Claim Adjustment_FK
Is Identifying Relationshiptrue
Child TableExplanation Of Benefits
Child MultiplicityZERO_TO_MANY
Child Referential Integrity: On DeleteNONE
Child Referential Integrity: On InsertNONE
Child Referential Integrity: On UpdateNONE
Parent TableClaim Adjustment
Parent MultiplicityONE
Parent Referential Integrity: On DeleteNONE
Parent Referential Integrity: On InsertNONE
Parent Referential Integrity: On UpdateNONE



 Explanation Of Benefit_Patient Financial Transaction_FK
Is Identifying Relationshiptrue
Child TableExplanation Of Benefits
Child MultiplicityZERO_TO_MANY
Child Referential Integrity: On DeleteNONE
Child Referential Integrity: On InsertNONE
Child Referential Integrity: On UpdateNONE
Parent TablePatient Financial Transaction
Parent MultiplicityONE
Parent Referential Integrity: On DeleteNONE
Parent Referential Integrity: On InsertNONE
Parent Referential Integrity: On UpdateNONE



 Explanation Of Benefit_Patient_FK
Is Identifying Relationshiptrue
Child TableExplanation Of Benefits
Child MultiplicityZERO_TO_MANY
Child Referential Integrity: On DeleteNONE
Child Referential Integrity: On InsertNONE
Child Referential Integrity: On UpdateNONE
Parent TablePatient
Parent MultiplicityONE
Parent Referential Integrity: On DeleteNONE
Parent Referential Integrity: On InsertNONE
Parent Referential Integrity: On UpdateNONE



 Explanation Of Benefit_Plan Member_FK
Is Identifying Relationshiptrue
Child TableExplanation Of Benefits
Child MultiplicityZERO_TO_MANY
Child Referential Integrity: On DeleteNONE
Child Referential Integrity: On InsertNONE
Child Referential Integrity: On UpdateNONE
Parent TablePlan Member
Parent MultiplicityONE
Parent Referential Integrity: On DeleteNONE
Parent Referential Integrity: On InsertNONE
Parent Referential Integrity: On UpdateNONE



 Explanation Of Benefit_Practitioner_FK
Is Identifying Relationshiptrue
Child TableExplanation Of Benefits
Child MultiplicityZERO_TO_MANY
Child Referential Integrity: On DeleteNONE
Child Referential Integrity: On InsertNONE
Child Referential Integrity: On UpdateNONE
Parent TablePractitioner
Parent MultiplicityONE
Parent Referential Integrity: On DeleteNONE
Parent Referential Integrity: On InsertNONE
Parent Referential Integrity: On UpdateNONE



 Explanation Of Benefits_Communication_FK
Is Identifying Relationshiptrue
Child TableExplanation Of Benefits
Child MultiplicityZERO_TO_MANY
Child Referential Integrity: On DeleteNONE
Child Referential Integrity: On InsertNONE
Child Referential Integrity: On UpdateNONE
Parent TableCommunication
Parent MultiplicityONE
Parent Referential Integrity: On DeleteNONE
Parent Referential Integrity: On InsertNONE
Parent Referential Integrity: On UpdateNONE

Primary Key Details

 Explanation Of Benefits PK
Key AttributeClaim Line Sk
Key AttributeClaim Adjustment Sk
Key AttributePatient Financial Transaction Sk
Key AttributePatient Sk
Key AttributePlan Member Sk
Key AttributePractitioner Sk
Key AttributeCommunication Sk
Key AttributeRelationship Type Code Sk
Key AttributeValid From Ts