OverviewTopPackage
Business Data Model Data Model

Package Claim

DescriptionA package that contains data elements related to both claims being submitted by the provider and post-adjudicated claims.


Diagrams
BDM - ClaimBDM - Claim
BDM - Claim AdjustmentBDM - Claim Adjustment
BDM - Claim AppealBDM - Claim Appeal
BDM - Claim CommunicationBDM - Claim Communication
BDM - Claim FraudBDM - Claim Fraud
BDM - Claim Line ItemBDM - Claim Line Item
BDM - Claim - OverviewBDM - Claim - Overview
BDM - Claim Processing And RecoveryBDM - Claim Processing And Recovery
BDM - Coordination Of BenefitsBDM - Coordination Of Benefits
BDM - Explanation Of BenefitsBDM - Explanation Of Benefits
ClaimClaim

Entities
Affiliated Healthcare ClaimAffiliated Healthcare Claim
ClaimClaim
Claim / APGClaim / APG
Claim / DRGClaim / DRG
Claim / OrganizationClaim / Organization
Claim / PatientClaim / Patient
Claim / Plan MemberClaim / Plan Member
Claim / PractitionerClaim / Practitioner
Claim AdjustmentClaim Adjustment
Claim AppealClaim Appeal
Claim AttachmentClaim Attachment
Claim ConditionClaim Condition
Claim Condition CodeClaim Condition Code
Claim Coverage Precedence AlterationClaim Coverage Precedence Alteration
Claim Fraud InvestigationClaim Fraud Investigation
Claim LineClaim Line
Claim Line AmountsClaim Line Amounts
Claim Line CodesClaim Line Codes
Claim Line OCE EditClaim Line OCE Edit
Claim Line Payment InformationClaim Line Payment Information
Claim OCE EditClaim OCE Edit
Claim PaymentClaim Payment
Claim ProcessingClaim Processing
Claim Processing CostClaim Processing Cost
Claim RecoveryClaim Recovery
Claim Remittance AdviceClaim Remittance Advice
Claim Value CodeClaim Value Code
COB / Claim Line / Coverage AgreementCOB / Claim Line / Coverage Agreement
Coordination Of BenefitsCoordination Of Benefits
Explanation Of BenefitsExplanation Of Benefits
Institutional Claim Line ItemInstitutional Claim Line Item
Pharmacy Claim Line ItemPharmacy Claim Line Item
Professional Claim Line ItemProfessional Claim Line Item
OverviewTopPackage
Business Data Model Data Model