Entity Claim Processing Cost Detail

DescriptionA financial expense that is incurred in dealing with a claim. The costs may be identified at a very detailed level (claim line) or may be at a higher level that relates to the whole claim.

For example:
The administrative cost incurred in adjudicating a claim.

Attributes
Claim Processing Cost SkClaim Processing Cost Sk
Cost Actual AmtCost Actual Amt
Cost Category Code SkCost Category Code Sk
Cost Code SkCost Code Sk
Cost Forecast AmtCost Forecast Amt
Currency Code SkCurrency Code Sk
Direct IndDirect Ind
Effective From DtEffective From Dt
Effective To DtEffective To Dt
Fixed IndFixed Ind
Load Info SkLoad Info Sk
Source Code SkSource Code Sk
Tenant SkTenant Sk
Time SpentTime Spent
Type Code SkType Code Sk
Valid From TsValid From Ts
Valid To TsValid To Ts

Relationship
Claim Processing Cost Detail_Anchor_FKClaim Processing Cost Detail_Anchor_FK

Primary Key
Claim Processing Cost Detail PKClaim Processing Cost Detail PK

Dependencies
 

Reverse Dependencies
 

Attribute Details

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



 Cost Actual Amt
DescriptionThe monetary amount corresponding to the cost related to a claim.
Data TypeStandards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse



 Cost Category Code Sk
DescriptionIndicates the nature of the claim processing cost.
Data TypeStandards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse



 Cost Code Sk
DescriptionIndicates a classification of the breakdown of the claim costs for claim statistical or financial reporting purposes.
Data TypeStandards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse



 Cost Forecast Amt
DescriptionThe anticipated or projected activity cost.
Data TypeStandards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse



 Currency Code Sk
DescriptionIndicates the currency used as the basis for all monetary amounts.
Data TypeStandards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse



 Direct Ind
DescriptionIndicates whether the cost is direct or indirect.
Data TypeStandards - Data Domains.ddm/Data Domains/Boolean Indicator [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



 Fixed Ind
DescriptionIndicates whether the cost is fixed or variable.
Data TypeStandards - Data Domains.ddm/Data Domains/Boolean Indicator [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



 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



 Time Spent
DescriptionThe time spent on the claim handling activity by the health plan, its providers, partners and intermediaries.
Data TypeStandards - Data Domains.ddm/Data Domains/Small Counter [SHORT]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
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



 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

 Claim Processing Cost Detail_Anchor_FK
Is Identifying Relationshiptrue
Child TableClaim Processing Cost Detail
Child MultiplicityZERO_TO_MANY
Child Referential Integrity: On DeleteNONE
Child Referential Integrity: On InsertNONE
Child Referential Integrity: On UpdateNONE
Parent TableClaim Processing Cost
Parent MultiplicityONE
Parent Referential Integrity: On DeleteNONE
Parent Referential Integrity: On InsertNONE
Parent Referential Integrity: On UpdateNONE

Primary Key Details

 Claim Processing Cost Detail PK
Key AttributeClaim Processing Cost Sk
Key AttributeValid From Ts