Last Updated: 7/22/2025 8:42:49 PM
Intergy Version: 22.00.00.00
PolicyMember
Table Definition Parent Tables Child Tables
Table Definition| Field | Datatype | Default | Null Option | Comment |
|---|---|---|---|---|
| PlanID | INTEGER | ? | MANDATORY | FK |
| PolicyNumber | CHARACTER(20) | MANDATORY | FK | |
| PersonID | INTEGER | ? | MANDATORY | FK |
| RelationToSub | CHARACTER(2) | MANDATORY | User selects relationship to subscriber code. Relationship to subscriber codes are defined in the LookupCode table for the lookup type 'Relation''. Codes for lookup type 'Relation' are not user definable. | |
| CoverageOrder | INTEGER | 0 | MANDATORY | Preferred plan order number for billing. User set. |
| DeductibleSource | CHARACTER(1) | OPTIONAL | Source that amount of deductible was obtained from. Possilbe values are: (I)nsurance (P)atient. | |
| DeductibleRemaining | DECIMAL(10,2) | 0 | OPTIONAL | Amount of deductible remaining. |
| DeductibleTimestamp | CHARACTER(14) | OPTIONAL | Timestamp remaining deductible was obtained. | |
| MemberNumber | CHARACTER(17) | OPTIONAL | Patient's member number for the policy. | |
| RecordStatus | CHARACTER(1) | MANDATORY | User selected record status for the policy member. RecordStatus is defined in the LookupCode table for the lookup type 'RecordStatus'. Codes for lookup type 'RecordStatus' are not user definable. Valid codes are (A)ctive and (I)nactive. | |
| 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. |
| InsuranceType | CHARACTER(2) | OPTIONAL | System defined. This field represents the type of insurance. Field is supported by the lookup types:[InsuranceType]. Values are defined in the LookupCode table for the above lookup types. | |
| RxBenefit | CHARACTER(1) | OPTIONAL | User set field to indicate that this policy is the patients plan to use when performing Rx formulary checking. | |
| ClaimMemberID | CHARACTER(29) | OPTIONAL | User entered value to be placed in box 1A of the HCFA 1500 claim form. This field is used to identify the policy member (patient) to the insurance company. The label of the this field may be redefined at the plan level. | |
| EDIMemberID | CHARACTER(29) | OPTIONAL | User entered value to identify the policy member (patient) to the insurance company when using EDI as the form of communication (e.g. eligibility), referrals, etc). Claims will still use the ClaimMemberID for providing the data for box 1A. The label of the this field may be redefined by the practice. | |
| Note | CHARACTER(60) | OPTIONAL | User entered note. | |
| FrontImageSID | INTEGER | ? | OPTIONAL | General file unique identifier. The unique identifier is obtained from the GENERAL sequence. Note - Partially obsoleted for new images (see Design 1586) |
| BackImageSID | INTEGER | ? | OPTIONAL | General file unique identifier. The unique identifier is obtained from the GENERAL sequence. Note - Partially obsoleted for new images (see Design 1586) |
| CopayClass | CHARACTER(6) | OPTIONAL | Specifies the default copay class for the policy member. | |
| ClaimMemberID2 | CHARACTER(29) | OPTIONAL | User entered value. This field is used as a second claim member ID or could be used to identify the policy member (patient) to a secondary insurance company. The label of this field may be redefined at the plan level. | |
| HL7Updated | CHARACTER(1) | OPTIONAL | This field indicates if HL7 has processed this table entry and will be used by the DB triggers. values "Y" or "N". | |
| FrontImageFileID | CHARACTER(15) | OPTIONAL | Front Image Storage Location ID
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| BackImageFileID | CHARACTER(15) | OPTIONAL | Back Image Storage Location ID
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| FrontImageScanStamp | CHARACTER(14) | OPTIONAL | User defined - Indicates when the image was last scanned. | |
| BackImageScanStamp | CHARACTER(14) | OPTIONAL | User defined - Indicates when the image was last scanned. | |
| FrontImageScanUserID | INTEGER | ? | OPTIONAL | FK - From MMUser table. User who Scanned the Front Image of an Insurance card |
| BackImageScanUserID | INTEGER | ? | OPTIONAL | FK - From MMUser table. User who Scanned the Back Image of an Insurance card |
| Parent Table | Join Phrase | When deleting parent record... |
|---|---|---|
| MMUser | PolicyMember.BackImageScanUserID = MMUser.MMUserSID | SET NULL if PolicyMember exists |
| MMUser | PolicyMember.FrontImageScanUserID = MMUser.MMUserSID | SET NULL if PolicyMember exists |
| GenFile | PolicyMember.BackImageSID = GenFile.GenFileSID | SET NULL if PolicyMember exists |
| GenFile | PolicyMember.FrontImageSID = GenFile.GenFileSID | SET NULL if PolicyMember exists |
| Person | PolicyMember.PersonID = Person.PersonID | CASCADE if PolicyMember exists |
| Policy | PolicyMember.PlanID = Policy.PlanID and PolicyMember.PolicyNumber = Policy.PolicyNumber |
CASCADE if PolicyMember exists |
| Child Table | Join Phrase | When deleting PolicyMember record... |
|---|---|---|
| Eligibility | Eligibility.PlanID = PolicyMember.PlanID and Eligibility.PolicyNumber = PolicyMember.PolicyNumber and Eligibility.PatientID = PolicyMember.PersonID |
CASCADE if Eligibility exists |
| LabOrderInsCoverage | LabOrderInsCoverage.PlanID = PolicyMember.PlanID and LabOrderInsCoverage.PolicyNumber = PolicyMember.PolicyNumber and LabOrderInsCoverage.PersonID = PolicyMember.PersonID |
RESTRICT if LabOrderInsCoverage exists |
| ChargeCoverage | ChargeCoverage.PlanID = PolicyMember.PlanID and ChargeCoverage.PolicyNumber = PolicyMember.PolicyNumber and ChargeCoverage.PersonID = PolicyMember.PersonID |
RESTRICT if ChargeCoverage exists |