ClaimTypeInProgType


Description

Claim type program type associations that define which claim types are available for specific program types, enabling program-specific claim processing rules.

Columns

Column Type Size Nulls Auto Default Children Parents Comments
BillingFrequency Unknown 0 null

Billing frequency - How often claims of this type can be billed
CPID int identity 4 √ null
ModifierInClaimType.fkCPID FK__ModifierInClaimType__ClaimTypeInProgType C
ProcCodeInClaimType.fkCPID FK__ProcCodeInClaimType__ClaimTypeInProgType C
RuleErrorInCP.fkCPID FK_RuleErrorInCP_ClaimTypeInProgType C
ServiceTypeInClaimType.fkCPID FK__ServiceTypeInClaimType__ClaimTypeInProgType C

Reference identifier - Foreign key reference to related entity or lookup table
fkClaimTypeID int 4 √ null
Claimtype.ClaimTypeID FK__ClaimTypeInProgType__Claimtype C

Foreign key reference - Reference to ClaimType table for data relationships
fkProgramID int 4 √ null
ProgramType.ProgramID FK__ClaimTypeInProgType__ProgType C

Foreign key reference - Reference to Program table for data relationships
IsDefault Unknown 0 null

Default flag - Whether this is the default claim type for this program
ReqAuth int 4 √ null

Numeric value - Quantity, count, or numeric measurement for ClaimTypeInProgType records
MaxUnit int 4 √ null

Numeric value - Quantity, count, or numeric measurement for ClaimTypeInProgType records
MaxUnitsPerDay Unknown 0 null

Maximum units per day - Maximum service units allowed per day for this claim type
MaxUnitsPerWeek Unknown 0 null

Maximum units per week - Maximum service units allowed per week
RequiresAuthorization Unknown 0 null

Authorization required - Whether claims of this type require prior authorization

Indexes

Constraint Name Type Sort Column(s)
PK_ClaimTypeInProgType Primary key Asc CPID
ID_ProgramID Performance Asc fkProgramID
IX_ClaimTypeID Performance Asc fkClaimTypeID

Relationships

Close relationships within degrees of separation