Last Updated: 7/22/2025 8:42:49 PM
Intergy Version: 22.00.00.00
Eligibility
Table Definition Parent Tables Child Tables
Table Definition| Field | Datatype | Default | Null Option | Comment |
|---|---|---|---|---|
| EligibilitySID | INTEGER | ? | MANDATORY | System generated unique id using the EDI sequence. |
| EligBatchRunSID | INTEGER | ? | MANDATORY | FK - From EligibilityBatchRun |
| PracticeID | INTEGER | ? | MANDATORY | FK - From Practice |
| StaffID | INTEGER | ? | MANDATORY | FK - From Staff |
| PatientID | INTEGER | ? | MANDATORY | FK - From Patient |
| PlanID | INTEGER | ? | MANDATORY | FK - From Plan |
| PolicyNumber | CHARACTER(20) | OPTIONAL | User entered ID Number of the patient's insurance policy. | |
| ApptSID | INTEGER | ? | OPTIONAL | FK - From Appointment |
| ServiceCenterID | INTEGER | ? | OPTIONAL | FK - From ServiceCenter |
| RequestDate | DATE | MANDATORY | Date the Eligibility request was made. | |
| RespChangeIndicator | CHARACTER(1) | OPTIONAL | Indicates whether a change in patient data has occurred between the 270 and 271 | |
| ResponseLastName | CHARACTER(35) | OPTIONAL | Response Patient Last Name | |
| ResponseFirstName | CHAR(35) | OPTIONAL | Response Patient First Name | |
| ResponseMiddleName | CHAR(35) | OPTIONAL | Response Patient Middle Name | |
| ResponseAddress | CHARACTER(55) | OPTIONAL | Response Patient Address | |
| ResponsePatCity | CHARACTER(30) | OPTIONAL | Response Patient City | |
| ResponsePatState | CHARACTER(2) | OPTIONAL | Response Patient State | |
| ResponsePatZip | CHARACTER(15) | OPTIONAL | Response Patient Zip | |
| ResponseDOB | DATE | OPTIONAL | Response Patient Date of Birth | |
| ResponseGender | CHARACTER(1) | OPTIONAL | Response Patient Gender | |
| RespRelToSubscriber | CHARACTER(2) | OPTIONAL | Patients relationship to the subscriber as defined by table 1069 of ANSI 271 spec. | |
| ResponseHandicap | CHARACTER(1) | OPTIONAL | "Y" value indicates an individual is handicapped; an "N" value indicates not handicapped. | |
| RespStudentStatCode | CHARACTER(1) | OPTIONAL | Code indicating the student status of the patient if 19 years of age or older, not handicapped and not the insured. Table 1220. | |
| RespBirthSeqNumber | INTEGER | 0 | OPTIONAL | The number assigned to each family member born with the same birth date. This number identifies birth sequence for multiple births allowing proper tracking and response of benefits for each dependent. |
| ResponseEligStatus | CHARACTER(3) | OPTIONAL | Response Patient Eligibility Status Numeric or character- table 1390 of ANSI spec. | |
| ResponseEligDateType | INTEGER | 0 | OPTIONAL | Date Type is dependent on the values form table 374 of ANSI 271 spec. |
| RespEligStartDate | DATE | OPTIONAL | Start Date of the Eligibility verification | |
| RespEligEndDate | DATE | OPTIONAL | End Date of the Eligibility verification | |
| RespTraceID | CHAR(50) | OPTIONAL | Obsoleted in version 9.00.00. Replaced by EligibilityTrace table. | |
| RespOriginatorTraceID | CHARACTER(15) | OPTIONAL | Obsoleted in version 9.00.00. Replaced by EligibilityTrace table. | |
| RespAuthNumber | CHARACTER(30) | OPTIONAL | Authorization or Approval Number | |
| TimeStamp | CHARACTER(14) | OPTIONAL | System generated date/time stamp record was last written. | |
| LastUser | INTEGER | ? | OPTIONAL | User ID of user that last wrote the record. |
| CreateStamp | CHARACTER(14) | OPTIONAL | System generated date/time stamp record was created. | |
| CreateUser | INTEGER | ? | OPTIONAL | User ID of user that created the record. |
| RequestServiceType | CHARACTER(2) | MANDATORY | User requested Code identifying the classification of service - Table 1365 of ANSI 271 spec. | |
| RequestStatus | CHARACTER(1) | OPTIONAL | Eligibility Request Status: (C)ompleted, (E)rror, (R)equested, (W)aiting | |
| RespMemberID | CHARACTER(30) | OPTIONAL | Member ID returned on the Eligibility Response | |
| RespErrorStatus | INTEGER | ? | OPTIONAL | Hierarchical Level of the Error: 1 - Payer 2 - Provider 3 - Patient (Subscriber or Dependent) |
| RespErrorCode | CHAR(2) | OPTIONAL | Error Code from Response (AAA03) | |
| RespFollowUp | CHARACTER(1) | OPTIONAL | Follow Up Code from Response (AAA04) | |
| RequestCount | INTEGER | Number_One | MANDATORY | Request Counter |
| ServiceDate | DATE | OPTIONAL | Date Service was rendered for a charge batch item. | |
| Note | CHAR(500) | Set_To_Empty_String | OPTIONAL | User entered note for the eligibility that was entered in manually. |
| RequestUserSID | INTEGER | ? | OPTIONAL | FK - from MMUser table. The user that requested the Eligibility. |
| Parent Table | Join Phrase | When deleting parent record... |
|---|---|---|
| MMUser | Eligibility.RequestUserSID = MMUser.MMUserSID | RESTRICT if Eligibility exists |
| PolicyMember | Eligibility.PlanID = PolicyMember.PlanID and Eligibility.PolicyNumber = PolicyMember.PolicyNumber and Eligibility.PatientID = PolicyMember.PersonID |
CASCADE if Eligibility exists |
| Appointment | Eligibility.ApptSID = Appointment.ApptSID and Eligibility.PracticeID = Appointment.PracticeID and Eligibility.ServiceCenterID = Appointment.ServiceCenterID |
CASCADE if Eligibility exists |
| Policy | Eligibility.PlanID = Policy.PlanID and Eligibility.PolicyNumber = Policy.PolicyNumber |
CASCADE if Eligibility exists |
| Staff | Eligibility.PracticeID = Staff.PracticeID and Eligibility.StaffID = Staff.StaffID |
CASCADE if Eligibility exists |
| Patient | Eligibility.PracticeID = Patient.PracticeID and Eligibility.PatientID = Patient.PatientID |
CASCADE if Eligibility exists |
| Child Table | Join Phrase | When deleting Eligibility record... |
|---|---|---|
| EligibilityBenefit | EligibilityBenefit.EligibilitySID = Eligibility.EligibilitySID | CASCADE if EligibilityBenefit exists |