| Dimensional Warehouse Model Data Model |
Description | An agreement detailing the circumstances and mechanisms under which healthcare benefits (money or services) will be delivered. Each benefit category in a benefit schedule will have an entry in coverage agreement that specifies the parameters for that benefit category. For example: Dental care coverage Prenatal care Routine exams |
Primary Key | |
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Dependencies | |
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Reverse Dependencies | |
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Attribute Details |
Description | Indicates how any additional members are identified. For example: By name Spouse and children |
Data Type | Standards - Data Domains.ddm/Data Domains/Tenant Common Code [VARCHAR(80)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Indicates how any additional members are identified. For example: By name Spouse and children |
Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Indicates how any additional members are identified. For example: By name Spouse and children |
Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | The surrogate key of the load information entry describing the details regarding the loading of the row in the atomic data warehouse. |
Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
Is Part Of PrimaryKey | false |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
Description | Indicates the benefit delivery frequency of coverage agreement. For example: - 1 exam every calendar year for mammograms - 6 exams from birth to 1 year of age for Well Child Care |
Data Type | Standards - Data Domains.ddm/Data Domains/Tenant Common Code [VARCHAR(80)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Indicates the benefit delivery frequency of coverage agreement. For example: - 1 exam every calendar year for mammograms - 6 exams from birth to 1 year of age for Well Child Care |
Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Indicates the benefit delivery frequency of coverage agreement. For example: - 1 exam every calendar year for mammograms - 6 exams from birth to 1 year of age for Well Child Care |
Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Indicates the unit of measure of the coverage agreement benefit. |
Data Type | Standards - Data Domains.ddm/Data Domains/Tenant Common Code [VARCHAR(80)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Indicates the unit of measure of the coverage agreement benefit. |
Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Indicates the unit of measure of the coverage agreement benefit. |
Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | The date upon which the agreement is considered legally binding, or in force. Depending on the legislation the bound date can be the date when the coverage agreement is signed by both parties and/or when the first premium has been paid. Derived from the status related information. |
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 |
Description | The specific co-insurance percentage applying to the coverage agreement on the policy. In other words the percentage of covered benefits that the member will be liable for up to their out-of-pocket or other maximums. |
Data Type | Standards - Data Domains.ddm/Data Domains/Percentage [FLOAT(2)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Concatenated values of a set of business attributes that uniquely identify the row. |
Data Type | Standards - Data Domains.ddm/Data Domains/Business Key [VARCHAR(255)] |
Is Part Of PrimaryKey | false |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
Description | A numeric surrogate key used to uniquely identify entities in the dimensional model. |
Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
Is Part Of PrimaryKey | true |
Is Required | true |
Is Derived | false |
Is Surrogate Key | true |
Description | A numeric surrogate key used to uniquely identify entities in the atomic model. |
Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
Is Part Of PrimaryKey | false |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
Description | Indicates the coverage agreement's current status. For Example: Active Cancelled Expired Final In Force In Process Initial Lapsed Not taken up Offered Rejected Suspended Terminated Under Negotiation |
Data Type | Standards - Data Domains.ddm/Data Domains/Tenant Common Code [VARCHAR(80)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Indicates the coverage agreement's current status. For Example: Active Cancelled Expired Final In Force In Process Initial Lapsed Not taken up Offered Rejected Suspended Terminated Under Negotiation |
Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Indicates the coverage agreement's current status. For Example: Active Cancelled Expired Final In Force In Process Initial Lapsed Not taken up Offered Rejected Suspended Terminated Under Negotiation |
Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Agreement Status Reason classifies agreements according to the motivation for changing the Agreement Status of the agreement. For example: Not eligible (if agreement rejected) Not taken up (if agreement rejected) |
Data Type | Standards - Data Domains.ddm/Data Domains/Tenant Common Code [VARCHAR(80)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Agreement Status Reason classifies agreements according to the motivation for changing the Agreement Status of the agreement. For example: Not eligible (if agreement rejected) Not taken up (if agreement rejected) |
Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Agreement Status Reason classifies agreements according to the motivation for changing the Agreement Status of the agreement. For example: Not eligible (if agreement rejected) Not taken up (if agreement rejected) |
Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Textual description of the Coverage. |
Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | The date on which the coverage actually terminates. This may pre- or post-date the Planned End Date. The termination date of the coverage is also represented in the status date for the terminated status. |
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 |
Description | Identifies an instance of an coverage agreement |
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 |
Description | Describes the kind or nature of the coverage agreement identifier. |
Data Type | Standards - Data Domains.ddm/Data Domains/Tenant Common Code [VARCHAR(80)] |
Is Part Of PrimaryKey | false |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
Description | Describes the kind or nature of the coverage agreement identifier. |
Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
Is Part Of PrimaryKey | false |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
Description | Describes the kind or nature of the coverage agreement identifier. |
Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER] |
Is Part Of PrimaryKey | false |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
Description | The percentage of eligible benefits that will be paid for under the coverage agreement. Applies to 'out-of-network' benefits, where applicable. |
Data Type | Standards - Data Domains.ddm/Data Domains/Percentage [FLOAT(2)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | The percentage of eligible benefits that will be paid for under the coverage agreement. Applies to 'in-network' benefits, where applicable. |
Data Type | Standards - Data Domains.ddm/Data Domains/Percentage [FLOAT(2)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Indicates the priority of the coverage in relation to other insurance policies that cover the same member for the same risks. |
Data Type | Standards - Data Domains.ddm/Data Domains/Tenant Common Code [VARCHAR(80)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Indicates the priority of the coverage in relation to other insurance policies that cover the same member for the same risks. |
Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Indicates the priority of the coverage in relation to other insurance policies that cover the same member for the same risks. |
Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | The date upon which the coverage agreement first starts. For renewable coverage agreements, this date represents the date of the original coverage agreement before any renewal. Derived from the status related information. |
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 |
Description | Type of the coverage this specification is for. For example: Dental Coverage Hospital Indemnity Coverage Pharmacy Coverage |
Data Type | Standards - Data Domains.ddm/Data Domains/Tenant Common Code [VARCHAR(80)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Type of the coverage this specification is for. For example: Dental Coverage Hospital Indemnity Coverage Pharmacy Coverage |
Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Type of the coverage this specification is for. For example: Dental Coverage Hospital Indemnity Coverage Pharmacy Coverage |
Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Set to 'Y' if this is the most recent row of a group having the same Surrogate Key. |
Data Type | Standards - Data Domains.ddm/Data Domains/Boolean Indicator [INTEGER] |
Is Part Of PrimaryKey | false |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
Description | The maximum age that a person can attain before becoming ineligible to receive benefits under this coverage. |
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 |
Description | The surrogate key of the load information entry describing the details regarding the loading of the row. |
Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
Is Part Of PrimaryKey | false |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
Description | Establishes a period where a set of attributes are true according to the business. |
Data Type | Standards - Data Domains.ddm/Data Domains/Date [DATE] |
Is Part Of PrimaryKey | false |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
Description | Ends a period of effectivity. |
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 |
Description | Time following the eligibility date during which the member may apply for insurance without evidence of insurability. For example: 31 days |
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 |
Description | Eligibility period unit specifies the unit of the coverage agreement eligibility period. |
Data Type | Standards - Data Domains.ddm/Data Domains/Tenant Common Code [VARCHAR(80)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Eligibility period unit specifies the unit of the coverage agreement eligibility period. |
Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Eligibility period unit specifies the unit of the coverage agreement eligibility period. |
Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Exposure amount unit of measure specifies the unit of measure of the coverage agreement exposure amount. |
Data Type | Standards - Data Domains.ddm/Data Domains/Tenant Common Code [VARCHAR(80)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Exposure amount unit of measure specifies the unit of measure of the coverage agreement exposure amount. |
Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Exposure amount unit of measure specifies the unit of measure of the coverage agreement exposure amount. |
Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Period following the termination date of the policy or coverage in which a claim can still be accepted, provided the claimed loss has occurred during the coverage period. For example: 2 years |
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 |
Description | Indicates the nature of commercial enterprise of the modeled organization. |
Data Type | Standards - Data Domains.ddm/Data Domains/Tenant Common Code [VARCHAR(80)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Indicates the nature of commercial enterprise of the modeled organization. |
Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Indicates the nature of commercial enterprise of the modeled organization. |
Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | The next date at which the enforce status of the coverage agreement must be re-evaluated or re-conducted. |
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 |
Description | The date upon which a review of the coverage agreement is planned. |
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 |
Description | The planned end date of the coverage. |
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 |
Description | Indicates whether or not the related benefits are restricted to in-plan network providers. For example: Yes No |
Data Type | Standards - Data Domains.ddm/Data Domains/Alphanumeric Small [VARCHAR(6)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Start date of policy coverage chosen as a date in the past preceding the policy inception date. For example: 1 June 2004 where inception date is 1 March 2005 |
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 |
Description | Indicates the currency as selected by the customer to be used on any monetary information provided to the customer. |
Data Type | Standards - Data Domains.ddm/Data Domains/Tenant Common Code [VARCHAR(80)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Indicates the currency as selected by the customer to be used on any monetary information provided to the customer. |
Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Indicates the currency as selected by the customer to be used on any monetary information provided to the customer. |
Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | The code that corresponds to the Source Code Sk. |
Data Type | Standards - Data Domains.ddm/Data Domains/Tenant Common Code [VARCHAR(80)] |
Is Part Of PrimaryKey | false |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
Description | The description that corresponds to the Source Type Cd. |
Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
Is Part Of PrimaryKey | false |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
Description | The origin of the data identifying the actual load source, vendor, manual key entry, or context of the data in a specific row in the database. |
Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER] |
Is Part Of PrimaryKey | false |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
Description | The surrogate key of the entry identifying the legal owner of the data. |
Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER] |
Is Part Of PrimaryKey | false |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
Description | Establishes a period where a set of attributes are true in the source system. This would be populated with the transaction timestamp and would be used for the snapshot date. |
Data Type | Standards - Data Domains.ddm/Data Domains/Timestamp [TIMESTAMP] |
Is Part Of PrimaryKey | false |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
Description | Ends a period of validity. |
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 |
Description | The period of time after the start date of the coverage agreement during which the member is not covered. Any loss occurring before the end of the waiting period will not be subject to a benefit. |
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 |
Description | Specifies the unit of measure of the coverage agreement waiting period. |
Data Type | Standards - Data Domains.ddm/Data Domains/Tenant Common Code [VARCHAR(80)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Specifies the unit of measure of the coverage agreement waiting period. |
Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Specifies the unit of measure of the coverage agreement waiting period. |
Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Primary Key Details |
Key Attribute | Coverage Agreement Dimension Dk |
| Dimensional Warehouse Model Data Model |