Columns
| Column | Type | Size | Nulls | Auto | Default | Children | Parents | Comments | |||
|---|---|---|---|---|---|---|---|---|---|---|---|
| claimID | int identity | 4 | √ | null |
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Primary key - Unique identifier for the medical claim |
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| caseID | int | 4 | √ | null |
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Case foreign key - Links to the patient case this claim belongs to |
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| patientID | int | 4 | √ | null |
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Patient foreign key - Links to the patient who received the services |
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| DOSFrom | datetime | 16,3 | √ | null |
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Date of service from - Start date of the service period for this claim |
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| DOSEnd | datetime | 16,3 | √ | null |
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Date of service to - End date of the service period for this claim |
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| StatusID | int | 4 | √ | null |
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Status identifier - Current status of the claim referencing iCS2.dbo.StatusType for centralized status management (Pending, Submitted, Paid, Denied, etc.) |
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| POS | int | 4 | √ | null |
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Place of service - Code indicating where the service was provided (Office, Home, School, etc.) |
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| ServiceTypeID | int | 4 | √ | null |
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Service type foreign key - Links to iCS2.dbo.ServiceType for centralized service type definitions and standardized service codes |
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| ProcedureID | int | 4 | √ | null |
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Procedure foreign key - Links to the procedure code (CPT, HCPCS) for the service |
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| ModifierID | int | 4 | √ | null |
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Modifier foreign key - Links to iCS2.dbo.Modifier for centralized billing modifier definitions and standardized modifier codes |
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| DiagnosisID | nvarchar | 20 | √ | null |
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Diagnosis identifier - Primary diagnosis code (ICD-10) justifying the service |
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| AmountCharged | money | 21,4 | √ | null |
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Amount charged - Total amount charged for the service |
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| AmountPaid | money | 21,4 | √ | null |
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Amount paid - Amount paid by insurance or other payer |
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| Unit | int | 4 | √ | null |
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Service units - Number of units of service provided (hours, sessions, etc.) |
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| EPSDT | int | 4 | √ | null |
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EPSDT flag - Early and Periodic Screening, Diagnostic and Treatment indicator |
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| COB | int | 4 | √ | null |
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Coordination of benefits - Flag indicating coordination of benefits with other insurance |
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| EMG | int | 4 | √ | null |
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Emergency flag - Indicates if service was provided as emergency care |
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| Location | varchar | 20 | √ | null |
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Service location - Specific location where service was provided |
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| EnteredBy | int | 4 | √ | null |
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Entered by user - User ID of the person who entered the claim |
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| UpdateBy | int | 4 | √ | null |
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Updated by user - User ID of the person who last updated the claim |
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| DateUpdate | datetime | 16,3 | √ | null |
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Update date - Date when the claim was last modified |
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| DateEntered | datetime | 16,3 | √ | null |
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Entry date - Date when the claim was entered into the system |
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| DateBilled | datetime | 16,3 | √ | null |
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Billing date - Date when the claim was submitted for payment |
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| DatePaid | datetime | 16,3 | √ | null |
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Payment date - Date when payment was received for the claim |
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| ServiceBy | int | 4 | √ | null |
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Service provider - Foreign key to the healthcare provider who delivered the service |
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| InvoiceID | int | 4 | √ | null |
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Invoice foreign key - Links to the invoice containing this claim |
Indexes
| Constraint Name | Type | Sort | Column(s) |
|---|---|---|---|
| PK__ClaimMedical__45D43599 | Primary key | Asc | claimID |
Relationships
Close relationships within degrees of separation
