| Business Data Model Data Model |
| Description | An approval that a healthcare practitioner receives from a health plan organization for a patient to receive treatment. |
| Dependencies | |
 NONE |
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| Reverse Dependencies | |
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| Attribute Details |
Actual End Date
| Description | The actual date upon which the activity was ended. |
| 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 |
Actual Labor Hours
| Description | The actual number of hours that it took to perform the activity. |
| 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 |
Actual Start Date
| Description | The actual date upon which the activity was started. |
| 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 |
Actual Time Spent
| Description | The actual time spent performing the activity. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Number Decimal Large [DECIMAL(15,6)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Authorization Id
| Description | The coverage application's permanent identifier assigned to track the authorization and all related billing documents. |
| 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 |
Authorized Number Of Treatments
| Description | The number of times that the authorized treatment may be administered to the patient without obtaining additional authorization. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Number Integer [INTEGER] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Contact Location
| Description | Location of the contact, which is required when a contact that may be external to a given enterprise must be referenced. |
| 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 |
Contact Role
| Description | Defines the relationship between the group or person authorizing the medical treatment and the patient being referred. When a referral is inter-enterprise in nature, there are some important relationships that must be identified. For example, it may be necessary to identify the contact representative at the clinic that sent the referral. For example: Employer Emergency Contact Federal Agency Insurance Company Next-of-Kin State Agency Other |
| 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 |
Currency
| Description | The currency that is used as the basis for all monetary amounts. |
| 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 |
Delay Reason
| Description | Indicates the cause of any discrepancy between planned and actual end dates. |
| 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 |
Insurance Plan Num
| Description | The ID of the coverage plan authorizing treatment. |
| 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 |
Medical Treatment Authorization Date
| Description | The effective date upon which the authorized treatment can begin which is covered and issued by the insurer. |
| 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 |
Medical Treatment Authorization Origination Date
| Description | The date upon which the authorization originated with the authorizing party. |
| 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 |
Medical Treatment Expiration Date
| Description | The expiration date upon which the authorized treatment will no longer be covered by the insurer. |
| 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 |
Name
| Description | The name of the medical treatment. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Name [VARCHAR(30)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Planned Duration
| Description | The time planned for the performing of the activity. This is the total elapsed time over which the activity is expected to be performed and not the planned labor hours. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Number Decimal Large [DECIMAL(15,6)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Planned End Date
| Description | The date upon which the medical treatment is planned to end. |
| 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 |
Planned Manpower
| Description | The planned labor hours required for the activity. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Number Decimal Large [DECIMAL(15,6)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Planned Start Date
| Description | Date upon which the activity is planned to start. |
| 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 |
Reimbursement Limit
| Description | The dollar limit for reimbursement specified by the coverage plan for the authorized treatment. |
| 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 |
Requested Number Of Treatments
| Description | The requested number of times that the treatment may be administered to the patient without obtaining additional authorization. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Number Integer [INTEGER] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
| Relationship Details |
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| Is Identifying Relationship | false |
| Child Table | Medical Treatment Authorization |
| Child Role Name | for procedure |
| 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_MANY |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Medical Treatment Authorization_Healthcare Insurer_FK
| Is Identifying Relationship | false |
| Child Table | Medical Treatment Authorization |
| Child Role Name | by insurer |
| 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 | Healthcare Insurer |
| Parent Multiplicity | ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Medical Treatment Authorization_Patient_FK
| Is Identifying Relationship | false |
| Child Table | Medical Treatment Authorization |
| Child Role Name | for patient |
| 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 |
| Parent Multiplicity | ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Medical Treatment Authorization_Practitioner_FK
| Is Identifying Relationship | false |
| Child Table | Medical Treatment Authorization |
| Child Role Name | servicing 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 | Practitioner |
| Parent Multiplicity | ZERO_TO_ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Medical Treatment Authorization_Encounter_FK
| Is Identifying Relationship | false |
| Child Table | Medical Treatment Authorization |
| 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 | ZERO_TO_ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Medical Treatment Authorization_Plan Member_FK
| Is Identifying Relationship | false |
| Child Table | Medical Treatment Authorization |
| 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 | Plan Member |
| Parent Multiplicity | ZERO_TO_ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Medical Treatment Authorization_Pharmacy Order Dispense_FK
| Is Identifying Relationship | false |
| Child Table | Medical Treatment Authorization |
| 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_MANY |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Medical Treatment Authorization_Procedure Code_FK
| Is Identifying Relationship | false |
| Child Table | Medical Treatment Authorization |
| 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 Code |
| Parent Multiplicity | ZERO_TO_MANY |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
| Business Data Model Data Model |