Business Data Model Data Model

Entity

Entity Insured

Description

The individual insured by a healthcare insurer.

Attributes
Birth Date
Birthplace Name
Contact Person Reason
Current Entitlement Reason
Dependent Of Military Recipient
Disability Status
Disability Type
Employee Num
Employer Contact Reason
Employment End Date Ts
Employment Start Date Ts
Employment Status
ERSD Ind
Gender
Guarantor Relationship
Healthcare Insurer Contact Reason
Healthcare Insurer Patient Member Num
Insured Citizenship Country
Job Class
Job Status
Job Title
Language
Level1 Txt
Level2 Txt
Level3 Txt
Level4 Txt
Living Arrangement
Living Dependency
Marital Status
Medicare Health Insurance Card Num
Medicare Status
Military Handicapped Program
Military Id
Military Non-Avail Cert On File Ind
Military Organization
Military Rank
Military Retire Date
Military Service
Military Station
Military Status
Nationality Country
Original Entitlement Reason
Protection Ind
Publicity Level
Religion Type
Social Security Num
Student Status
VIP

Relationship
Insured_Party Name_FK
Insured_Provider Patient Insurance_FK
Insured_Party Name_FK1
Insured_Party Name_FK2
Insured_Party Name_FK3

Dependencies
NONE

Reverse Dependencies

Attribute Details

Birth Date

Description	Date of birth of the insured.
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

Birthplace Name

Description	A textual description of the place an individual was born.
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

Contact Person Reason

Description	A textual description of the reason(s) a person should be contacted regarding the insured.
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

Current Entitlement Reason

Description	Indicates why an individual is still in an entitlement program.
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

Dependent Of Military Recipient

Description	Specifies if the individual is a military recipient dependent.
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

Disability Status

Description	Indicates any permanent or transient handicapped conditions. Also known as ambulatory status.
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

Disability Type

Description	Indicates the nature of an individual's disability. For example: Wheelchair bound Visually impaired Deaf
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

Employee Num

Description	The insured's employee number.
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

Employer Contact Reason

Description	A textual description of the reason(s) that an employer of an individual.
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

Employment End Date Ts

Description	The date and time that the employment ended.
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

Employment Start Date Ts

Description	The date and time that the employment began.
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

Employment Status

Description	The employment status of an individual. For example: Full-time employed Part-time employed Self-employed, Contract, per diem Leave of absence (for example, Family leave, sabbatical, etc.) Temporarily unemployed Unemployed Retired On active military duty Other Unknown
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

ERSD Ind

Description	Indication of whether the individual is in End State Renal Disease.
Data Type	Standards - Data Domains.ddm/Data Domains/Boolean Indicator [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Gender

Description	Identifies the gender of an individual.
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

Guarantor Relationship

Description	Indicates the relationship of the guarantor to the insured.
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

Healthcare Insurer Contact Reason

Description	Indicates how and why the healthcare insurer should be contacted. For example: Medicare claim status Medicaid claim status Name/address change
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

Healthcare Insurer Patient Member Num

Description	An identifying number assigned by the payor for each individual covered by the insurance policy issued to the insured. For example, each individual family member may have a different member number from the insurance policy number issued to the head of household.
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

Insured Citizenship Country

Description	Indicates the insured's country of citizenship.
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

Job Class

Description	Indicates the classification of an individual's job.
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

Job Status

Description	Indicates the current status of an individual's job.
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

Job Title

Description	Descriptive name of the individual's occupation. For example: Systems Analyst Accountant
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

Language

Description	Identifies a language an individual can speak, read and / or write. May also identify the language or dialect in which a comment or text is recorded.
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

Level1 Txt

Description	An employer group defined element defining a level of employee, such as division, region, pay grade, etc.”
Data Type	Standards - Data Domains.ddm/Data Domains/Text Very Small [VARCHAR(20)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Level2 Txt

Description	An employer group defined element defining a level of employee, such as division, region, pay grade, etc.”
Data Type	Standards - Data Domains.ddm/Data Domains/Text Very Small [VARCHAR(20)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Level3 Txt

Description	An employer group defined element defining a level of employee, such as division, region, pay grade, etc.”
Data Type	Standards - Data Domains.ddm/Data Domains/Text Very Small [VARCHAR(20)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Level4 Txt

Description	An employer group defined element defining a level of employee, such as division, region, pay grade, etc.”
Data Type	Standards - Data Domains.ddm/Data Domains/Text Very Small [VARCHAR(20)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Living Arrangement

Description	Indicates the situation that an individual lives in at his/her residential address. For example: A - Alone F - Family I - Institution R - Relative U - Unknown S - Spouse Only
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

Living Dependency

Description	Indicates any dependency that relates to an individual in their day to day lives. For example: S Spouse Dependent M Medical Supervision Required C Small Children Dependent O Other U Unknown
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

Marital Status

Description	Indicates the current marital status of an individual. For example: Married Single Divorced Widow
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

Medicare Health Insurance Card Num

Description	The Medicare Health Insurance Number (HIN), assigned by CMS or other regulatory agencies.
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

Medicare Status

Description	Indicates the status of an individual in a Medicare program.
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

Military Handicapped Program

Description	Indicates a military program for the handicapped in which the individual is enrolled.
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

Military Id

Description	Military ID number, defined by CMS or other regulatory agencies, which uniquely identifies a patient's military policy.
Data Type	Standards - Data Domains.ddm/Data Domains/Identifier [VARCHAR(80)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Military Non-Avail Cert On File Ind

Description	Indicates whether or not a military non-available certificate is on file.
Data Type	Standards - Data Domains.ddm/Data Domains/Boolean Indicator [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Military Organization

Description	Description of the military organization to which the individual is associated.
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

Military Rank

Description	Identifies the military rank/grade of an individual.
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

Military Retire Date

Description	The date upon which the individual retired from the military service.
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

Military Service

Description	The military service branch of the individual as defined by CMS or other regulatory agencies. For example: USA US Army USN US Navy USAF US Air Force USMC US Marine Corps USCG US Coast Guard USPHS US Public Health Service NOAA National Oceanic and Atmospheric Administration NATO North Atlantic Treaty Organization AUSA Australian Army AUSN Australian Navy AUSAF Australian Air Force
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

Military Station

Description	Description of a specific military station.
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

Military Status

Description	The military status of an individual as defined by CMS or other regulatory agencies. For example: ACT Active duty RET Retired DEC Deceased
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

Nationality Country

Description	Indicates the nation or national grouping to which a person belongs. This information may be different from a person's citizenship in countries in which multiple nationalities are recognized (for example, Spain: Basque, Catalan, etc.).
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

Original Entitlement Reason

Description	Indicates why the individual was in an entitlement program to begin with.
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

Protection Ind

Description	Identifies the individual's protection, which determines whether or not access to information about this person should be restricted from users who do not have adequate authority. 1 restrict access 0 do not restrict access
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

Publicity Level

Description	Indicates what level of publicity is allowed for an individual. For example: No Publicity Family Only
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

Religion Type

Description	Indicates the religion practiced by an individual.
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

Social Security Num

Description	The individual's social security number.
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

Student Status

Description	Indicates whether the individual is currently a student, and whether the individual is a full-time or part-time student. 1 Student 0 Not a student
Data Type	Standards - Data Domains.ddm/Data Domains/Boolean Indicator [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

VIP

Description	Indicates that the individual is considered a very important person (VIP) such as ahead of state or religious leader.
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

Relationship Details

Insured_Party Name_FK

Is Identifying Relationship	false
Child Table	Insured
Child Role Name	has name
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	Party Name
Parent Multiplicity	ZERO_TO_ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

Insured_Provider Patient Insurance_FK

Is Identifying Relationship	false
Child Table	Insured
Child Role Name	has policy
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

Insured_Party Name_FK1

Is Identifying Relationship	false
Child Table	Insured
Child Role Name	has contact person
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	Party Name
Parent Multiplicity	ZERO_TO_ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

Insured_Party Name_FK2

Is Identifying Relationship	false
Child Table	Insured
Child Role Name	has mothers maiden name
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	Party Name
Parent Multiplicity	ZERO_TO_ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

Insured_Party Name_FK3

Is Identifying Relationship	false
Child Table	Insured
Child Role Name	has military sponsor
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	Party Name
Parent Multiplicity	ZERO_TO_ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

Overview

Top

Package

Entity

Business Data Model Data Model