Last Updated: 9/24/2025 12:09:38 PM
Intergy Version: 22.00.00.00
PlanClaimData
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 |
| PracticeName | CHARACTER(30) |   | OPTIONAL | System set practice name. |
| PatientName | CHAR(200) |   | OPTIONAL | System set patient name. |
| PatientSex | CHARACTER(1) |   | OPTIONAL | Patient sex. |
| PatientMaritalStatus | CHARACTER(1) |   | OPTIONAL | Patient marital status. |
| PatientPhoneNumber | CHARACTER(20) |   | OPTIONAL | Phone number. |
| PatientEmploymentStatus | CHARACTER(1) |   | OPTIONAL | Patient Employment Status. |
| PatientAddressLine1 | CHARACTER(40) |   | OPTIONAL | Line 1 of address. User entered. |
| PatientAddressCity | CHARACTER(20) |   | OPTIONAL | City. User entered. |
| PatientAddressState | CHARACTER(2) |   | OPTIONAL | Two letter code of the state. User entered. |
| PatientAddressZip | CHARACTER(10) |   | OPTIONAL | Zip code. User entered. |
| PatientFormatDOB | CHARACTER(20) |   | OPTIONAL | |
| PlanName | CHARACTER(50) |   | OPTIONAL | |
| PlanAddressLine1 | CHARACTER(40) |   | OPTIONAL | Line 1 of address. User entered. |
| PlanAddressCity | CHARACTER(20) |   | OPTIONAL | City. User entered. |
| PlanAddressState | CHARACTER(2) |   | OPTIONAL | Two letter code of the state. User entered. |
| PlanAddressZip | CHARACTER(10) |   | OPTIONAL | Zip code. User entered. |
| SubscriberName | CHARACTER(50) |   | OPTIONAL | Subscriber name. |
| SubscriberNumber | CHARACTER(20) |   | OPTIONAL | |
| SubscriberEmployerName | CHARACTER(50) |   | OPTIONAL | |
| SubscriberGovtProgram | CHARACTER(1) |   | OPTIONAL | |
| SubscriberSex | CHARACTER(1) |   | OPTIONAL | Subscriber sex. |
| SubscriberFormatDOB | CHARACTER(20) |   | OPTIONAL | |
| SubscriberPhoneNumber | CHARACTER(20) |   | OPTIONAL | Subscriber phone number. |
| SubscriberPlanCode | CHARACTER(20) |   | OPTIONAL | System set subscriber plan code. |
| SubscriberAddressLine1 | CHARACTER(40) |   | OPTIONAL | Line 1 of address. User entered. |
| SubscriberAddressCity | CHARACTER(20) |   | OPTIONAL | City. User entered. |
| SubscriberAddressState | CHARACTER(2) |   | OPTIONAL | Two letter code of the state. User entered. |
| SubscriberAddressZip | CHARACTER(10) |   | OPTIONAL | Zip code. User entered. |
| SubscriberEmploymentStatus | CHARACTER(1) |   | OPTIONAL | Subscriber Employment Status. |
| PatientRelToSubscriber | CHARACTER(1) |   | OPTIONAL | |
| SubscriberGroupNumber | CHARACTER(20) |   | OPTIONAL | |
| FormType | CHARACTER(1) |   | OPTIONAL | User entered type of forms to be included in the batch. Possible values are: (P)aper, (E)mc |
| AssignBenefits | CHARACTER(1) |   | OPTIONAL | System set assigned benefits flag. |
| DiagCode | CHARACTER(10) |   | OPTIONAL | System set diagnosis code. |
| ProcedureCode | CHARACTER(10) |   | OPTIONAL | System set procedure code. |
| OtherSubscriberPlanID | INTEGER | ?   | OPTIONAL | System set secondary plan ID. |
| OtherGroupNumber | CHARACTER(20) |   | OPTIONAL | |
| OtherSubscriberPolicyNumber | CHARACTER(20) |   | OPTIONAL | System set secondary policy number. |
| OtherSubscriberPlanName | CHARACTER(50) |   | OPTIONAL | |
| OtherSubscriberEmployerName | CHARACTER(50) |   | OPTIONAL | |
| OtherSubscriberGovtProgram | CHARACTER(1) |   | OPTIONAL | |
| OtherSubscriberName | CHARACTER(50) |   | OPTIONAL | Other subscriber (insured) name. |
| OtherSubscriberSex | CHARACTER(1) |   | OPTIONAL | Other subscriber (insured) sex. |
| OtherSubscriberFormatDOB | CHARACTER(20) |   | OPTIONAL | |
| OtherSubscriberPlanCode | CHARACTER(20) |   | OPTIONAL | System set plan code. |
| ToDate | DATE |   | OPTIONAL | System set to service date. |
| AilmentName | CHARACTER(30) |   | OPTIONAL | System set ailment name. |
| AilmentEmpRelated | CHARACTER(1) |   | OPTIONAL | |
| AilmentAutoAccident | CHARACTER(1) |   | OPTIONAL | |
| AilmentAutoAccidentState | CHARACTER(2) |   | OPTIONAL | |
| AilmentOtherAccident | CHARACTER(1) |   | OPTIONAL | |
| FirstSymptomDate | DATE |   | OPTIONAL | |
| SimilarIllnessDate | DATE |   | OPTIONAL | |
| DisabilityStartDate | DATE |   | OPTIONAL | |
| DisabilityEndDate | DATE |   | OPTIONAL | |
| HospitalAdmitDate | DATE |   | OPTIONAL | |
| HospitalDischargeDate | DATE |   | OPTIONAL | |
| OutsideLab | CHARACTER(1) |   | OPTIONAL | |
| OutsideLabCharge | DECIMAL(10,2) | 0   | OPTIONAL | |
| BillingProviderName | CHARACTER(50) |   | OPTIONAL | Billing provider name.. |
| BillingProviderPhoneNumber | CHARACTER(20) |   | OPTIONAL | Billing provider phone number. |
| BillingProviderSSN | CHARACTER(11) |   | OPTIONAL | Billing provider SSN. |
| BillingProviderPINNumber | CHARACTER(20) |   | OPTIONAL | |
| BillingProviderGroupNumber | CHARACTER(20) |   | OPTIONAL | |
| BillingProviderFederalTaxID | CHARACTER(20) |   | OPTIONAL | Billing provider's federal tax id. |
| BillingProviderLine1 | CHARACTER(40) |   | OPTIONAL | Line 1 of address. User entered. |
| BillingProviderCity | CHARACTER(20) |   | OPTIONAL | City. User entered. |
| BillingProviderState | CHARACTER(2) |   | OPTIONAL | Two letter code of the state. User entered. |
| BillingProviderZip | CHARACTER(10) |   | OPTIONAL | Zip code. User entered. |
| RefProviderIDNumber | CHARACTER(20) |   | OPTIONAL | Referring doctor alternate ID number. |
| RefProviderName | CHARACTER(50) |   | OPTIONAL | Referring provider name. |
| MedicaidResubCode | CHARACTER(20) |   | OPTIONAL | |
| OriginalRefNo | CHARACTER(20) |   | OPTIONAL | |
| PriorAuthorizationNumber | CHARACTER(30) |   | OPTIONAL | |
| ConditionCode | CHARACTER(2) |   | OPTIONAL | |
| OccurrenceCode | CHARACTER(2) |   | OPTIONAL | |
| OccurrenceDate | DATE |   | OPTIONAL | |
| OccurrenceSpanCode | CHARACTER(2) |   | OPTIONAL | |
| OccurrenceSpanFromDate | DATE |   | OPTIONAL | |
| OccurrenceSpanToDate | DATE |   | OPTIONAL | |
| ValueCode | CHARACTER(2) |   | OPTIONAL | |
| ValueAmount | DECIMAL(10,2) | 0   | OPTIONAL | |
| FirstSymptomFormatDate | CHARACTER(20) |   | OPTIONAL | |
| SimilarIllnessFormatDate | CHARACTER(20) |   | OPTIONAL | |
| DisabilityStartFormatDate | CHARACTER(20) |   | OPTIONAL | |
| DisabilityEndFormatDate | CHARACTER(20) |   | OPTIONAL | |
| HospitalAdmitFormatDate | CHARACTER(20) |   | OPTIONAL | |
| HospitalDischargeFormatDate | CHARACTER(20) |   | OPTIONAL | |
| ClaimFormCode | CHARACTER(8) |   | OPTIONAL | |
| ServiceCenterName | CHARACTER(50) |   | OPTIONAL | Service center name. |
| ServiceCenterLine1 | CHARACTER(40) |   | OPTIONAL | Line 1 of address. User entered. |
| ServiceCenterCity | CHARACTER(20) |   | OPTIONAL | City. User entered. |
| ServiceCenterState | CHARACTER(2) |   | OPTIONAL | Two letter code of the state. User entered. |
| ServiceCenterZip | CHARACTER(10) |   | OPTIONAL | Zip code. User entered. |
| HospitalAdmitHour | CHARACTER(2) |   | OPTIONAL | System set hospital admission hour. |
| HospitalAdmitType | CHARACTER(6) |   | OPTIONAL | System set hospital admission type. |
| HospitalAdmitSource | CHARACTER(6) |   | OPTIONAL | System set hospital admission source. |
| HospitalDischargeHour | CHARACTER(2) |   | OPTIONAL | System set hospital discharge hour. |
| DoctorAcceptAssignment | CHARACTER(6) |   | OPTIONAL | System set flag (Y/N) which indicates if the doctor accepts assignment. |
| PatientReleaseInfo | CHARACTER(1) |   | OPTIONAL | System set flag (Y/N) which indicates if the patient has signed a release of medical information form. |
| PatientRelToOtherSubscriber | CHARACTER(2) |   | OPTIONAL | System set relationship code that indicates the patient's relationship to the other insured. |
| OtherSubscriberEmpStatus | CHARACTER(2) |   | OPTIONAL | System set employment status of the other insured party (e.g. secondary). |
| SubscriberEmployerLocation | CHARACTER(40) |   | OPTIONAL | The insurance subscriber's employer location (city, state). |
| OtherSubscriberEmpLocation | CHARACTER(40) |   | OPTIONAL | The other insurance subscriber's employer location (city, state). |
| ProcedureDate | DATE |   | OPTIONAL | System set date that the procedure was performed. |
| GroupBilling | CHARACTER(20) |   | OPTIONAL | Flag to indicate if the claim is for a group of doctors rather than just one. |
| PatientAuthorizePayment | CHARACTER(1) |   | OPTIONAL | Flag to indicate if the a patients medical infor is to be released. |
| Parent Table | Join Phrase | When deleting parent record... |
|---|---|---|
| PlanClaim | PlanClaimData.PlanID = PlanClaim.PlanID and PlanClaimData.PolicyNumber = PlanClaim.PolicyNumber and PlanClaimData.ClaimSID = PlanClaim.ClaimSID |
CASCADE if PlanClaimData exists |
| Child Table | Join Phrase | When deleting PlanClaimData record... |
|---|---|---|
| PlanClaimLineItemData | PlanClaimLineItemData.PlanID = PlanClaimData.PlanID and PlanClaimLineItemData.PolicyNumber = PlanClaimData.PolicyNumber and PlanClaimLineItemData.ClaimSID = PlanClaimData.ClaimSID |
CASCADE if PlanClaimLineItemData exists |