AP_CLAIM_PROV_RESP

Description: |
This table contains the provider responsibility information for AP Claim procedures.
To link this table’s service line information back to a claim header, join this table to AP_CLAIM_PROC_IDS on the TX_ID column. If you need to report on claim service lines specific to Cost Sharing Reduction (CSR), join this table instead to AP_CLAIM_PROC_IDS_CSR on the TX_ID column.

Primary Key

Column Name | Ordinal Position |
--- | --- | ---
TX_ID | 1 |
LINE | 2 |

Column Information

| Name | Type | Discontinued? |
--- | --- | --- | --- | ---
1 | TX_ID | NUMERIC | No |
The unique ID of the AP Claim procedure transaction.
2 | LINE | INTEGER | No |
The line number of the provider responsibility for this transaction record.
3 | PROV_RESP_AMT | NUMERIC | No |
The dollar amount for a specific provider responsibility.
4 | PRV_RESP_SRC_TP_C_NAME | VARCHAR | No |
The type of provider responsibility.
May contain organization-specific values: No
Category Entries:
Submission Policy
Before Benefit Penalty
Denial Via EOB
Not Covered By Plan
Bundle Adjustment
5 | EOB_CODE_ID_EOB_CODE_NAME | VARCHAR | No |
The name of the processing code.
6 | PROV_RESP_OVRD_AMT | NUMERIC | No |
The user-entered override to the dollar amount a specific provider responsibility. If present, the value in this column overrides the value in PRV_RESP_AMT.