PatientInsurance


Description

Patient insurance information managing insurance coverage details for patients including policy information, coverage periods, and billing parameters. This table stores comprehensive insurance data needed for claims processing, eligibility verification, and coordination of benefits across multiple insurance plans.

Columns

Column Type Size Nulls Auto Default Children Parents Comments
patientInsID int identity 4 null

Primary key - Unique identifier for the patient insurance record

InsurCariID int 4 null
InsurCarrier.InsurCariID FK__PatientIn__Insur__43EBED27 C

Insurance carrier foreign key - Links to the insurance carrier/company providing coverage

patientID int 4 null
Patient.PatientID FK_PatientInsurance_Patient C

Patient foreign key - Links to the patient who has this insurance coverage

PolicyType int 4 null

Policy type - Type of insurance policy (Primary, Secondary, Tertiary, etc.)

IdentityNumber nvarchar 100 null

Policy number - Insurance policy or member identification number

InsuredFirstName varchar 50 null

Insured first name - First name of the person who holds the insurance policy

InsuredLastName varchar 50 null

Insured last name - Last name of the person who holds the insurance policy

InsuredDOB datetime 16,3 null

Insured date of birth - Birth date of the policy holder for verification

InsuredGender varchar 20 null

Insured gender - Gender of the policy holder

Address varchar 50 null

Insured address - Primary address of the policy holder

City varchar 50 null

Insured city - City where the policy holder resides

State varchar 50 null

Insured state - State where the policy holder resides

Zip varchar 10 null

Insured ZIP code - Postal code for the policy holder’s address

Telephone varchar 30 null

Insured phone - Phone number of the policy holder

GroupPolicyName varchar 50 null

Group policy name - Name of the group policy (employer, association, etc.)

GroupPolicyNum varchar 30 null

Group policy number - Group policy identification number

Copay money 21,4 null

Copayment amount - Fixed copayment amount required for services

ManageCare int 4 null

Managed care flag - Indicates if this is a managed care plan requiring authorizations

PatientToInsured varchar 30 null

Patient relationship - Relationship of patient to policy holder (Self, Child, Spouse, etc.)

PolicyFrom datetime 16,3 null

Policy effective date - Date when insurance coverage begins

PolicyTo datetime 16,3 null

Policy expiration date - Date when insurance coverage ends

PercentCovered numeric 20 null

Coverage percentage - Percentage of costs covered by this insurance plan

AssignOfBenefit varchar 1 null

Assignment of benefits - Flag indicating if benefits are assigned to provider

AnnualDeductible money 21,4 null

Annual deductible - Annual deductible amount for this insurance plan

AnotherPlan varchar 1 null

Other coverage flag - Indicates if patient has other insurance coverage

SignatureOnFile varchar 1 null

Signature on file - Flag indicating if patient signature is on file for billing

DateSign datetime 16,3 null

Signature date - Date when patient signature was obtained

Address2 varchar 50 null

Insured address line 2 - Secondary address line for policy holder

Indexes

Constraint Name Type Sort Column(s)
PK__PatientInsurance__42F7C8EE Primary key Asc patientInsID
IX_PatientID Performance Asc patientID

Relationships