Entity Claimant

DescriptionA party who submits a claim for an incurred service.

For example:
Acme healthcare provider, as claimant of multiple procedures it has carried out under the relevant health plan product.
Michael Gregory, as claimant of a benefit under his personal health plan product.

Attributes
Claimant ConfirmationClaimant Confirmation
Claimant Confirmation DateClaimant Confirmation Date
Claimant TypeClaimant Type

Generalization
Claimant_Party Role_GenClaimant_Party Role_Gen

Dependencies
 NONE

Reverse Dependencies
 

Attribute Details

 Claimant Confirmation
DescriptionIndicates whether the claimant is accepted as being a valid member of the insurance policy against which the claim was filed.
Data TypeStandards - Data Domains.ddm/Data Domains/Boolean Indicator [INTEGER]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse



 Claimant Confirmation Date
DescriptionThe date upon which which the claimant confirmation status was set.
Data TypeStandards - Data Domains.ddm/Data Domains/Date [DATE]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse



 Claimant Type
DescriptionIndicates nature of the relationship between a claimant and the healthcare insurer.
Data TypeStandards - Data Domains.ddm/Data Domains/Enumeration [VARCHAR(20)]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse

Generalization Details

 Claimant_Party Role_Gen
SupertypeParty Role
SubtypeClaimant
Transform AsTABLE