Capitation Payment AmtInterest AmtLate Claim Filing Penalty AmtLoan Repayment AmtPeriodic Interim Payment Amt
| Business Data Model Data Model |
| Description | A communication that a health plan organization sends to a healthcare provider explaining the settlement of a submitted claim . The remittance advice will contain details of the payment amounts and will typically accompany or precede the payment. |
| Attributes | |
| Capitation Payment Amt |
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| Interest Amt |
|
| Late Claim Filing Penalty Amt |
|
| Loan Repayment Amt |
|
| Periodic Interim Payment Amt |
|
| Relationship | |
 Claim Remittance Advice_Claim_FK |
|
| Generalization | |
 Claim Remittance Advice_Explanation of Payment_Gen |
|
| Dependencies | |
 NONE |
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| Reverse Dependencies | |
| |
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| Attribute Details |
Capitation Payment Amt
| Description | The amount of the claim payment representing capitation amounts. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount Large [DECIMAL(20,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Interest Amt
| Description | The portion of the claim payment relating to interest obligations. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount Large [DECIMAL(20,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Late Claim Filing Penalty Amt
| Description | The amount that the provider is charged for late filing of claims. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount Large [DECIMAL(20,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Loan Repayment Amt
| Description | An adjustment to the claim payment in respect to loan amounts being repaid. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount Large [DECIMAL(20,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Periodic Interim Payment Amt
| Description | The monetary value of any periodic interim payment included in the claim payment. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount Large [DECIMAL(20,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
| Relationship Details |
Claim Remittance Advice_Claim_FK
| Is Identifying Relationship | false |
| Child Table | Claim Remittance Advice |
| Child Role Name | relates to |
| 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 | Claim |
| Parent Role Name | is explained in |
| Parent Multiplicity | ZERO_TO_ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
| Generalization Details |
Claim Remittance Advice_Explanation of Payment_Gen
| Supertype | Explanation of Payment |
| Subtype | Claim Remittance Advice |
| Transform As | TABLE |
| Business Data Model Data Model |