Overview Top Package Entity

Atomic Warehouse Model Data Model

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Entity Encounter Pre-Certification

Description

An association between an encounter and a coverage eligibility. It records insurance information for certifying the need for patient care.

Attributes

Case Manager

Certificate End Dt

Certificate Start Dt

Certification Contact

Certification Date Ts

Certification Modified Date Ts

Certification Num

Certified By Sk

Coverage Eligibility Sk

Days Valid

Effective From Dt

Effective To Dt

Encounter Sk

Load Info Sk

Non-Concur Appeal Reason Code Sk

Non-Concur Code Sk

Non-Concur Effective Date Ts

Physician Reviewer Sk

Pre-Admission Certification Code Sk

Relationship Type Code Sk

Second Opinion Documentation Received Code Sk

Second Opinion Dt

Second Opinion Provider Sk

Second Opinion Status Code Sk

Sent By Sk

Source Code Sk

Tenant Sk

Valid From Ts

Valid To Ts

Relationship

Encounter Pre-Certification_Provider Patient Insurance_FK

Encounter Pre-Certification_Encounter_FK

Encounter Pre-Certification_Name_FK

Encounter Pre-Certification_Name_FK1

Encounter Pre-Certification_Name_FK2

Encounter Pre-Certification_Name_FK3

Primary Key

Encounter Pre-Certification PK

Dependencies

Reverse Dependencies

Attribute Details

 Case Manager

Description	The name of the entity which is handling this particular patient's case. For example: UR nurse A specific healthcare facility location
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

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 Certificate End Dt

Description	The date upon which the certificate for the specific patient care expires.
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

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 Certificate Start Dt

Description	The date upon which the certificate for the specific patient care commences.
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

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 Certification Contact

Description	The name of the party contacted at the certification agency that granted the certification and communicated the certification number.
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

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 Certification Date Ts

Description	The date and time that indicates when insurance was certified to exist for the patient.
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

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 Certification Modified Date Ts

Description	The date and time that the certification was modified.
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

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 Certification Num

Description	A number assigned by the certification agency.
Data Type	Standards - Data Domains.ddm/Data Domains/Alphanumeric [VARCHAR(80)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

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 Certified 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

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 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

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 Days Valid

Description	The number of days for which this certification is valid. This value applies to denied, pending, or approved days.
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

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 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

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 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

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 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

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 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

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 Non-Concur Appeal Reason Code Sk

Description	Indicates the reason that an appeal was made on a non-concur for certification.
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

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 Non-Concur Code Sk

Description	Indicates the reason for denying a pre-certification request.
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

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 Non-Concur Effective Date Ts

Description	The date and time of the non-concurrence classification.
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

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 Physician Reviewer 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

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 Pre-Admission Certification Code Sk

Description	Identifies the certification code associated with the pre-admission process.
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

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 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

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 Second Opinion Documentation Received Code Sk

Description	Indicates if accompanying documentation has been received by the provider.
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

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 Second Opinion Dt

Description	The date upon which the second opinion was obtained.
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

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 Second Opinion Provider 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

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 Second Opinion Status Code Sk

Description	Status of the second opinion.
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

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 Sent 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

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 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

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 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

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 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

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 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

 Encounter Pre-Certification_Provider Patient Insurance_FK

Is Identifying Relationship	true
Child Table	Encounter Pre-Certification
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

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 Encounter Pre-Certification_Encounter_FK

Is Identifying Relationship	true
Child Table	Encounter Pre-Certification
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

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 Encounter Pre-Certification_Name_FK

Is Identifying Relationship	false
Child Table	Encounter Pre-Certification
Child Role Name	certified 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

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 Encounter Pre-Certification_Name_FK1

Is Identifying Relationship	false
Child Table	Encounter Pre-Certification
Child Role Name	sent 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

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 Encounter Pre-Certification_Name_FK2

Is Identifying Relationship	false
Child Table	Encounter Pre-Certification
Child Role Name	second opinion provider
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

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 Encounter Pre-Certification_Name_FK3

Is Identifying Relationship	false
Child Table	Encounter Pre-Certification
Child Role Name	physician reviewer
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 Pre-Certification PK

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

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Overview Top Package Entity

Atomic Warehouse Model Data Model