| Dimensional Warehouse Model Data Model |
Description | An inquiry into whether a member is eligible to receive a specific healthcare benefits. Such an inquiry will normally occur between a healthcare provider and a health plan organization. |
Primary Key | |
![]() |
Dependencies | |
![]() |
|
![]() |
Reverse Dependencies | |
![]() |
Attribute Details |
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 | 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 | Code identifying the actual type of the entity as per the type hierarchy defined in the business data model. |
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 | Code identifying the actual type of the entity as per the type hierarchy defined in the business data model. |
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 | 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 | false |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
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 | 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 | 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 | false |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
Description | A numeric surrogate key used to uniquely identify entities in the atomic model. |
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 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 | Indicates the healthcare function of the party making the inquiry, where the inquirer is a healthcare provider. For example: Admitting Attending Billing Consulting Covering Home Health Care Hospital Laboratory Other Physician Performing Pharmacist Pharmacy Primary Care Physician Referring Rural Health Clinic Skilled Nursing Facility Submitting Supervising |
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 healthcare function of the party making the inquiry, where the inquirer is a healthcare provider. For example: Admitting Attending Billing Consulting Covering Home Health Care Hospital Laboratory Other Physician Performing Pharmacist Pharmacy Primary Care Physician Referring Rural Health Clinic Skilled Nursing Facility Submitting Supervising |
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 | A textual or codified response to the enquiry. For example: Active coverage Cannot process Inactive pending investigation Not deemed a medical necessity |
Data Type | Standards - Data Domains.ddm/Data Domains/Text Medium [VARCHAR(255)] |
Is Part Of PrimaryKey | false |
Is Required | false |
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 | false |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
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 | In the content of the United States Medicaid Program, the amount of healthcare costs that must be met personally before an individual qualifies for Medicaid coverage. This may be the amount that was effective at the time the enquiry was made or the amount by which the individual's spend down amount should be decreased as a result of this medical service occurring. |
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 |
Description | Indicates whether or not the subject of the enquiry is the subscriber or the dependent. |
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 |
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 | false |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
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 | 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 | false |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
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 | 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 | false |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
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 | 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 | false |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
Description | The generated unique key for a Procedure. |
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 date proposed for the admission where an admission is being enquired about. |
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 end of the period for which the enquiring party wish to confirm whether an individual has Health plan membership entitlements. |
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 start of the period for which the enquiring party wish to confirm whether an individual has Health plan membership entitlements. |
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 | Place of Service (POS) codes are two-digit codes, typically placed on healthcare professional claims to indicate the setting in which a healthcare task was executed. The Centers for Medicare & Medicaid Services (CMS) maintain POS codes. This relates to a specific medical service being proposed or enquired about. For example: 11 OFFICE 53 COMMUNITY MENTAL HEALTH CENTER |
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 | Place of Service (POS) codes are two-digit codes, typically placed on healthcare professional claims to indicate the setting in which a healthcare task was executed. The Centers for Medicare & Medicaid Services (CMS) maintain POS codes. This relates to a specific medical service being proposed or enquired about. For example: 11 OFFICE 53 COMMUNITY MENTAL HEALTH CENTER |
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 proposed for a healthcare task, where a particular healthcare task is being enquired about. |
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 type of healthcare task being enquired about. For example: Anesthesia Blood Charges Consultation Diagnostic Lab Diagnostic X-Ray Medical Care Other Medical Radiation Therapy Surgical Surgical Assistance Used Durable Medical Equipment |
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 type of healthcare task being enquired about. For example: Anesthesia Blood Charges Consultation Diagnostic Lab Diagnostic X-Ray Medical Care Other Medical Radiation Therapy Surgical Surgical Assistance Used Durable Medical Equipment |
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 | 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 | false |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
Description | Indicates the role of the proposed provider in relation to the medical service being enquired about. For example: Admitting Attending Billing Consulting Covering Home Health Care Hospital Laboratory Other Physician Performing Pharmacist Pharmacy Primary Care Physician Referring Rural Health Clinic Skilled Nursing Facility Submitting Supervising |
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 role of the proposed provider in relation to the medical service being enquired about. For example: Admitting Attending Billing Consulting Covering Home Health Care Hospital Laboratory Other Physician Performing Pharmacist Pharmacy Primary Care Physician Referring Rural Health Clinic Skilled Nursing Facility Submitting Supervising |
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 | 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 medical specialty required by a healthcare provider to carry out the medical service being enquired about. |
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 medical specialty required by a healthcare provider to carry out the medical service being enquired about. |
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 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 | 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 | false |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
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 | 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 | Indicates the nature of the benefit eligibility enquiry. |
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 the benefit eligibility enquiry. |
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 | 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 |
Relationship Details |
Is Identifying Relationship | false |
Child Table | Benefit Eligibility Enquiry Fact |
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 | Provider Dimension |
Parent Multiplicity | ONE |
Parent Referential Integrity: On Delete | NONE |
Parent Referential Integrity: On Insert | NONE |
Parent Referential Integrity: On Update | NONE |
Is Identifying Relationship | false |
Child Table | Benefit Eligibility Enquiry Fact |
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 Dimension |
Parent Multiplicity | ONE |
Parent Referential Integrity: On Delete | NONE |
Parent Referential Integrity: On Insert | NONE |
Parent Referential Integrity: On Update | NONE |
Is Identifying Relationship | false |
Child Table | Benefit Eligibility Enquiry Fact |
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 | Point Of Care Location Dimension |
Parent Multiplicity | ONE |
Parent Referential Integrity: On Delete | NONE |
Parent Referential Integrity: On Insert | NONE |
Parent Referential Integrity: On Update | NONE |
Is Identifying Relationship | false |
Child Table | Benefit Eligibility Enquiry Fact |
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 | Referral Fact |
Parent Multiplicity | ONE |
Parent Referential Integrity: On Delete | NONE |
Parent Referential Integrity: On Insert | NONE |
Parent Referential Integrity: On Update | NONE |
Is Identifying Relationship | false |
Child Table | Benefit Eligibility Enquiry Fact |
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 Dimension |
Parent Multiplicity | ONE |
Parent Referential Integrity: On Delete | NONE |
Parent Referential Integrity: On Insert | NONE |
Parent Referential Integrity: On Update | NONE |
Is Identifying Relationship | false |
Child Table | Benefit Eligibility Enquiry Fact |
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 | Diagnosis Event Dimension |
Parent Multiplicity | ONE |
Parent Referential Integrity: On Delete | NONE |
Parent Referential Integrity: On Insert | NONE |
Parent Referential Integrity: On Update | NONE |
Is Identifying Relationship | false |
Child Table | Benefit Eligibility Enquiry Fact |
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 | Provider Dimension |
Parent Multiplicity | ONE |
Parent Referential Integrity: On Delete | NONE |
Parent Referential Integrity: On Insert | NONE |
Parent Referential Integrity: On Update | NONE |
Is Identifying Relationship | false |
Child Table | Benefit Eligibility Enquiry Fact |
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 Dimension |
Parent Multiplicity | ONE |
Parent Referential Integrity: On Delete | NONE |
Parent Referential Integrity: On Insert | NONE |
Parent Referential Integrity: On Update | NONE |
Is Identifying Relationship | false |
Child Table | Benefit Eligibility Enquiry Fact |
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 | Insurance Policy Dimension |
Parent Multiplicity | ONE |
Parent Referential Integrity: On Delete | NONE |
Parent Referential Integrity: On Insert | NONE |
Parent Referential Integrity: On Update | NONE |
Primary Key Details |
Key Attribute | Benefit Eligibility Enquiry Fact Dk |
| Dimensional Warehouse Model Data Model |