Entity Authorization Result Detail

DescriptionThe decision that the health plan organization reaches in respect of the request for approval to provide healthcare treatment to a member.

Attributes
Authorization NumAuthorization Num
Authorization Result Reason Code SkAuthorization Result Reason Code Sk
Authorization Result SkAuthorization Result Sk
Authorization Result Type Code SkAuthorization Result Type Code Sk
Effective From DtEffective From Dt
Effective To DtEffective To Dt
Level Of Service Rating Code SkLevel Of Service Rating Code Sk
Load Info SkLoad Info Sk
Number Of Service Units ApprovedNumber Of Service Units Approved
Proposed DtProposed Dt
Second Opinion IndSecond Opinion Ind
Source Code SkSource Code Sk
Tenant SkTenant Sk
Type Code SkType Code Sk
Urgency Rating Code SkUrgency Rating Code Sk
Valid From TsValid From Ts
Valid To TsValid To Ts

Relationship
Authorization Result Detail_Anchor_FKAuthorization Result Detail_Anchor_FK

Primary Key
Authorization Result Detail PKAuthorization Result Detail PK

Dependencies
 

Reverse Dependencies
 

Attribute Details

 Authorization Num
DescriptionPrior authorization or medical certification, assigned by healthcare insurer or pharmacy benefit management company.
Data TypeStandards - Data Domains.ddm/Data Domains/Alphanumeric [VARCHAR(80)]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse



 Authorization Result Reason Code Sk
DescriptionClassifies the reason of the authorization result.
Data TypeStandards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse



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



 Authorization Result Type Code Sk
DescriptionClassifies an authorization result according to its type.
Data TypeStandards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
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



 Level Of Service Rating Code Sk
DescriptionIndicates the intensity of service required or provided for a particular procedure.
Data TypeStandards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER]
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



 Number Of Service Units Approved
DescriptionThe number of units of medical service that were approved.
Data TypeStandards - Data Domains.ddm/Data Domains/Number Integer [INTEGER]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse



 Proposed Dt
DescriptionThe proposed date upon which the service is to be performed.
Data TypeStandards - Data Domains.ddm/Data Domains/Date [DATE]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse



 Second Opinion Ind
DescriptionIndicates whether or not a second medical opinion is required for this authorization result.

For example:
0 = No Second Opinion Required
1 = Second Opinion Required
Data TypeStandards - Data Domains.ddm/Data Domains/Boolean Indicator [INTEGER]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
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



 Type Code Sk
DescriptionIdentifies the actual type of the entry based on the entity type hierarchy defined in the business data model.
Data TypeStandards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER]
Is Part Of PrimaryKeyfalse
Is Requiredtrue
Is Derivedfalse
Is Surrogate Keyfalse



 Urgency Rating Code Sk
DescriptionIndicates the urgency of performing a particular procedure.
Data TypeStandards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
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

 Authorization Result Detail_Anchor_FK
Is Identifying Relationshiptrue
Child TableAuthorization Result Detail
Child MultiplicityZERO_TO_MANY
Child Referential Integrity: On DeleteNONE
Child Referential Integrity: On InsertNONE
Child Referential Integrity: On UpdateNONE
Parent TableAuthorization Result
Parent MultiplicityONE
Parent Referential Integrity: On DeleteNONE
Parent Referential Integrity: On InsertNONE
Parent Referential Integrity: On UpdateNONE

Primary Key Details

 Authorization Result Detail PK
Key AttributeAuthorization Result Sk
Key AttributeValid From Ts