CLM_CVG_INFO

Description: |
This table stores claim level coverage related information.

Primary Key

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

Column Information

| Name | Type | Discontinued? |
--- | --- | --- | --- | ---
1 | CLAIM_PRINT_ID | NUMERIC | No |
The unique identifier for the Claim Info record.
2 | LINE | INTEGER | No |
The line number for the information associated with this record. Multiple pieces of information can be associated with this record.
3 | ALL_CVG_ID | NUMERIC | No |
Stores coverage ID.
4 | AUTH_NUM | VARCHAR | No |
Stores the authorization number for the corresponding coverage.
5 | AUTH_TYP_C_NAME | VARCHAR | No |
Store the authorization type for the corresponding coverage.
May contain organization-specific values: No
Category Entries:
Referral Number
Prior Authorization Number
6 | AUTH_SOURCE_REFERRAL_ID | NUMERIC | No |
The unique ID of the referral or auth/cert record when the authorization number on the row was found in the referral or auth/cert.
7 | AUTH_SOURCE_AUTH_ID | NUMERIC | No |
The unique ID of the service level authorization record when the authorization number on the row was found in the authorization record.
8 | AUTH_SOURCE_HSP_ACCOUNT_ID | NUMERIC | No |
The unique ID of the hospital account when the authorization number on the row was found in the account.
9 | AUTH_SOURCE_CLAIM_ID | NUMERIC | No |
The unique ID of the hospital account when the authorization number on the row was found in the account.
10 | AUTH_NUM_SOURCE_C_NAME | VARCHAR | No |
The auth number search precedence category ID identifying where the authorization number was found.
May contain organization-specific values: No
Category Entries:
None
Claim Info - Authorization Number (PB:CLM-341; HB:HAR-7053)
Referral - Effective Coverages Authorization Number (RFL-18062)
Referral - Default Authorization Number (RFL-60)
Referral - Effective Coverages Pre-Certification Number (RFL-18064)
Referral - Default Pre-Certification Number (RFL-18010)
Episode Authorization Code
Bed Days Table - Authorization Number (RFL-8513/8527)
Dental Plan - Authorization Number (DTP-302)
Referral - SAR/TAR (RFL-210/250/269)
Referral - Service Level Auths (ETR-118; AUT-18062)
11 | AUTH_PB_RFL_RECORD_SOURCE_C_NAME | VARCHAR | No |
The Professional Billing referral source search precedence category ID identifying where the source referral or auth/cert record was found.
May contain organization-specific values: No
Category Entries:
Referral assigned to the charge (ETR 116)
Authorization assigned to the charge (AUT 105)
Order associated with the charge (ORD 3300)
Encounter associated with the charge (EPT 23015)
12 | AUTH_HB_RFL_RECORD_SOURCE_C_NAME | VARCHAR | No |
The Hospital Billing referral source search precedence category ID identifying where the source referral or auth/cert record was found.
May contain organization-specific values: No
Category Entries:
Hospital account (HAR 130)
Authorization assigned to the charge (AUT 105)
Order associated with the charge (ORD 3300)
Authorization associated with the encounter of the charge (EPT 23017)
Technical referral associated with the encounter of the charge (EPT 23019)
Primary referral associated with the encounter of the charge (EPT 23015)
Authorization associated with the primary contact on the hospital account (EPT 23017)
Technical referral associated with the primary contact on the hospital account (EPT 23019)
Primary referral associated with the primary contact on the hospital account (EPT 23015)
13 | AUTH_SOURCE_TREATMENT_PLAN_ID | VARCHAR | No |
The unique ID of the dental treatment plan record when the authorization number on the row was found in the treatment plan.