Last Updated: 7/22/2025 8:42:49 PM
Intergy Version: 22.00.00.00
PlanClaim
Table Definition Parent Tables Child Tables
Table Definition| Field | Datatype | Default | Null Option | Comment |
|---|---|---|---|---|
| PlanID | INTEGER | ? | MANDATORY | FK |
| PolicyNumber | CHARACTER(20) | MANDATORY | FK | |
| ClaimSID | INTEGER | ? | MANDATORY | FK |
| CurrentStatus | CHARACTER(8) | OPTIONAL | PlanClaim current status. Acceptable values are READY, BILLED, PAID, REBILL, FORWARDED. | |
| SubmittalCount | INTEGER | 0 | MANDATORY | This field records the number of times the claim has been submitted to a given carrier. |
| PracticeID | INTEGER | ? | OPTIONAL | System set practice ID. |
| PatientID | INTEGER | ? | OPTIONAL | System set patient ID. |
| AccountSID | INTEGER | ? | OPTIONAL | System set account ID. |
| AccountNumber | CHARACTER(14) | OPTIONAL | System set account number. | |
| BilledDate | DATE | OPTIONAL | Date claim was billed to plan. | |
| FromDate | DATE | OPTIONAL | System set from service date. | |
| TotalClaimAmount | DECIMAL(10,2) | 0 | OPTIONAL | System set total amount of the claim. |
| CoverageOrder | INTEGER | 0 | OPTIONAL | Preferred plan order number for billing. |
| PlanICN | CHARACTER(20) | OPTIONAL | Claim number (internal control number) as assigned by plan. | |
| BillingProviderID | INTEGER | ? | OPTIONAL | System set billing provider ID. |
| BilledThruDate | DATE | OPTIONAL | System set date the claim was billed through. | |
| AilmentSID | INTEGER | ? | OPTIONAL | System set ailment ID. |
| SubscriberID | INTEGER | ? | OPTIONAL | System set subscriber ID. |
| PerformingProviderID | INTEGER | ? | OPTIONAL | System set attending provider ID. |
| RefProviderID | INTEGER | ? | OPTIONAL | |
| ReferralSID | INTEGER | ? | OPTIONAL | System set referral ID. |
| OtherSubscriberID | INTEGER | ? | OPTIONAL | System set secondary subscriber ID. |
| ServiceCenterID | INTEGER | ? | OPTIONAL | |
| SortField | CHARACTER | OPTIONAL | System built field which stores the values of the fields used to sort the batch. | |
| 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. |
| SatisfiedDate | DATE | ? | OPTIONAL | If the claim is satisfied then this field will contain the date the claim was satisfied, otherwise the date will be ?. |
| PrevResponsible | CHARACTER(1) | No_Value__N_ | OPTIONAL | Indicates if the coverage order has previously been responsible for the charge. Possible values: (Y)es, (N)o |
| ClaimFlagCode | CHAR(12) | OPTIONAL | FK - ClaimFlag | |
| LastRebilledDateTime | DATETIME | OPTIONAL | When the claim was last rebilled. | |
| FollowupDate | DATE | ? | OPTIONAL | Follow-up date for a plan claim record. Used by Claim Control. |
| Parent Table | Join Phrase | When deleting parent record... |
|---|---|---|
| Policy | PlanClaim.PlanID = Policy.PlanID and PlanClaim.PolicyNumber = Policy.PolicyNumber |
RESTRICT if PlanClaim exists |
| Claim | PlanClaim.ClaimSID = Claim.ClaimSID | CASCADE if PlanClaim exists |
| Child Table | Join Phrase | When deleting PlanClaim record... |
|---|---|---|
| PlanClaimActivity | PlanClaimActivity.PlanID = PlanClaim.PlanID and PlanClaimActivity.PolicyNumber = PlanClaim.PolicyNumber and PlanClaimActivity.ClaimSID = PlanClaim.ClaimSID |
CASCADE if PlanClaimActivity exists |
| ClaimNote | ClaimNote.PlanID = PlanClaim.PlanID and ClaimNote.PolicyNumber = PlanClaim.PolicyNumber and ClaimNote.ClaimSID = PlanClaim.ClaimSID |
SET NULL if ClaimNote exists |
| PlanClaimDiag | PlanClaimDiag.PlanID = PlanClaim.PlanID and PlanClaimDiag.PolicyNumber = PlanClaim.PolicyNumber and PlanClaimDiag.ClaimSID = PlanClaim.ClaimSID |
CASCADE if PlanClaimDiag exists |
| PlanClaimStatus | PlanClaimStatus.PlanID = PlanClaim.PlanID and PlanClaimStatus.PolicyNumber = PlanClaim.PolicyNumber and PlanClaimStatus.ClaimSID = PlanClaim.ClaimSID |
CASCADE if PlanClaimStatus exists |
| PlanClaimRemit | PlanClaimRemit.PlanID = PlanClaim.PlanID and PlanClaimRemit.PolicyNumber = PlanClaim.PolicyNumber and PlanClaimRemit.ClaimSID = PlanClaim.ClaimSID |
CASCADE if PlanClaimRemit exists |
| PlanClaimData | PlanClaimData.PlanID = PlanClaim.PlanID and PlanClaimData.PolicyNumber = PlanClaim.PolicyNumber and PlanClaimData.ClaimSID = PlanClaim.ClaimSID |
CASCADE if PlanClaimData exists |
| PlanClaimLineItem | PlanClaimLineItem.PlanID = PlanClaim.PlanID and PlanClaimLineItem.PolicyNumber = PlanClaim.PolicyNumber and PlanClaimLineItem.ClaimSID = PlanClaim.ClaimSID |
CASCADE if PlanClaimLineItem exists |