Advanced Beneficiary NoticeExtended AmtFee ScheduleFiller Order NumMedically Necessary Duplicate Procedure ReasonNational Drug CodePatient Type CodeProcedure CodeQuantityTransaction CodeUnit AmtUnit Cost
| Business Data Model Data Model |
| Description | A financial transaction that pertains to a person who is being or has been treated by the healthcare organization. For example: Medication charge Surgery Charge Patient payment Co-payment |
| Generalization | |
 Generalization1 |
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| Dependencies | |
 NONE |
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| Reverse Dependencies | |
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| Attribute Details |
Advanced Beneficiary Notice
| Description | Status of the patient's or the patient's representative's consent for responsibility to pay for potentially uninsured services. This element is introduced to satisfy CMS Medical Necessity requirements for outpatient services. This element indicates (a) whether the associated diagnosis codes for the service are subject to medical necessity procedures, (b) whether, for this type of service, the patient has been informed that they may be responsible for payment for the service, and (c) whether the patient agrees to be billed for this service. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Enumeration [VARCHAR(20)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Extended Amt
| Description | The amount of a patient financial transaction. May be the total price for multiple items. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Fee Schedule
| Description | Standard charges for goods and services within an organization. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Enumeration [VARCHAR(20)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Filler Order Num
| Description | The number used by a filler to uniquely identify a result. Used when the billing system is requesting observational reporting justification for a charge. |
| 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 |
Medically Necessary Duplicate Procedure Reason
| Description | Indicates the reason why a duplicate procedure for the same patient within the same date of service has been determined to be medically necessary. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Enumeration [VARCHAR(20)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
National Drug Code
| Description | Indicates a unique identification code used for any drug intended for human use. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Enumeration [VARCHAR(20)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Patient Type Code
| Description | Indicates the type code assigned to the patient for an episode of care (visit or stay). |
| Data Type | Standards - Data Domains.ddm/Data Domains/Enumeration [VARCHAR(20)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Procedure Code
| Description | A unique code that identifies a procedure within a coding system. Standard procedure code sets include Current Procedural Terminology (CPT), SNOMED and Healthcare Common and Universal Billing (UB) Revenue codes. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Enumeration [VARCHAR(20)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Quantity
| Description | Quantity of items associated with this Patient Financial Transaction. |
| 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 |
Transaction Code
| Description | Indicates a unique transaction code per transaction type (a procedure, supply item, or test for charges) as defined by the institution. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Enumeration [VARCHAR(20)] |
| Is Part Of PrimaryKey | false |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Unit Amt
| Description | Unit price of one unit of the item referenced by the patient financial transaction. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Unit Cost
| Description | The unit cost of a transaction. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
| Relationship Details |
Financial Transaction_Practitioner_FK
| Is Identifying Relationship | false |
| Child Table | Patient Financial Transaction |
| Child Role Name | performed 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 | Practitioner |
| Parent Multiplicity | ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Financial Transaction_Practitioner_FK1
| Is Identifying Relationship | false |
| Child Table | Patient Financial Transaction |
| Child Role Name | ordered 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 | Practitioner |
| Parent Multiplicity | ZERO_TO_ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Financial Transaction_Point Of Care Location_FK
| Is Identifying Relationship | false |
| Child Table | Patient Financial Transaction |
| Child Role Name | assigned location |
| 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 | Point Of Care Location |
| Parent Multiplicity | ZERO_TO_ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Financial Transaction_Provider_FK
| Is Identifying Relationship | false |
| Child Table | Patient Financial Transaction |
| Child Role Name | responsible department |
| 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 | Provider |
| Parent Multiplicity | ZERO_TO_ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Financial Transaction_Insurance Summary_FK
| Is Identifying Relationship | false |
| Child Table | Patient Financial Transaction |
| Child Role Name | charged against |
| 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 | ZERO_TO_ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Patient Financial Transaction_Patient_FK
| Is Identifying Relationship | false |
| Child Table | Patient Financial Transaction |
| Child Role Name | pertains to |
| Child Multiplicity | ONE_TO_MANY |
| Child Referential Integrity: On Delete | NONE |
| Child Referential Integrity: On Insert | NONE |
| Child Referential Integrity: On Update | NONE |
| Parent Table | Patient |
| Parent Multiplicity | ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Patient Financial Transaction_Practitioner_FK
| Is Identifying Relationship | false |
| Child Table | Patient Financial Transaction |
| Child Role Name | enterred 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 | Practitioner |
| Parent Multiplicity | ZERO_TO_ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Financial Transaction_Patient Account_FK
| Is Identifying Relationship | false |
| Child Table | Patient Financial Transaction |
| Child Role Name | tracked 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 | Patient Account |
| Parent Multiplicity | ZERO_TO_ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Patient Financial Transaction_Procedure_FK
| Is Identifying Relationship | false |
| Child Table | Patient Financial Transaction |
| Child Role Name | cash flow for |
| 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 | Procedure |
| Parent Multiplicity | ZERO_TO_ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Patient Financial Transaction_Pharmacy Order Dispense_FK
| Is Identifying Relationship | false |
| Child Table | Patient Financial Transaction |
| 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 | Pharmacy Order Dispense |
| 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 |
Generalization1
| Supertype | Financial Transaction |
| Subtype | Patient Financial Transaction |
| Transform As | TABLE |
| Business Data Model Data Model |