REFERRAL_5

Description: |
The REFERRAL_5 table is a continuation of the REFERRAL_4 table. The REFERRAL_* tables are the primary tables for referral information stored in the system.

Primary Key

Column Name | Ordinal Position |
--- | --- | ---
REFERRAL_ID | 1 |

Column Information

| Name | Type | Discontinued? |
--- | --- | --- | --- | ---
1 | REFERRAL_ID | NUMERIC | No |
The unique identifier for the referral record.
2 | GEN_RFL_SEC_SINCE_MIDNIGHT_7 | NUMERIC | No |
This contains information from generic referral time item 7.
3 | GEN_RFL_SEC_SINCE_MIDNIGHT_8 | NUMERIC | No |
This contains information from generic referral time item 8.
4 | GEN_RFL_SEC_SINCE_MIDNIGHT_9 | NUMERIC | No |
This contains information from generic referral time item 9.
5 | GEN_RFL_SEC_SINCE_MIDNIGHT_10 | NUMERIC | No |
This contains information from generic referral time item 10.
6 | RPT_REF_TO_CNTRCT_YN | VARCHAR | No |
Stores an override value that indicates the referred to provider/location/vendor/department should be considered contracted or not for Medicare Advantage ODAG reporting. If NULL, system defined logic will be used. If Y, a user marked the provider as contracted (CP in ODAG). If N, a user marked the provider as non-contracted (NCP in ODAG).
May contain organization-specific values: No
Category Entries:
No
Yes
7 | RPT_REF_BY_CNTRCT_YN | VARCHAR | No |
Stores an override value that indicates the referred by provider/location/department should be considered contracted or not for Medicare Advantage ODAG reporting. If NULL, system defined logic will be used. If Y, a user marked the provider as contracted (CP in ODAG). If N, a user marked the provider as non-contracted (NCP in ODAG).
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
8 | LIVING_SITUATION_C_NAME | VARCHAR | No |
Describes who the patient or child lives with.
May contain organization-specific values: Yes
No Entries Defined
9 | FIRST_APPOINTMENT_BY_DATE | DATETIME | No |
The date that the first appointment for the referral should occur by.
10 | SENIORITY_DATE | DATETIME | No |
The Seniority Date for the referral which represents a 'start date' that might have been set before the referral was created.
11 | CASE_WORKER_NAME | VARCHAR | No |
The case manager of the child psychology case.
12 | CHILD_SERVICE_C_NAME | VARCHAR | No |
Indicates the child welfare service role in connection with child psychology services.
May contain organization-specific values: Yes
No Entries Defined
13 | PARENTAL_RESP_C_NAME | VARCHAR | No |
Indicates which entity has parental responsibility for the patient.
May contain organization-specific values: Yes
No Entries Defined
14 | CONSENT_TO_TREAT_STAT_C_NAME | VARCHAR | No |
Indicates the status of obtaining the patient's consent in connection with the referral's transfer of medical record information.
May contain organization-specific values: Yes
No Entries Defined
15 | FORWARDED_EVALUATION_DATE | DATETIME | No |
This date represents the date an external organization evaluated or triaged the referral before forwarding it to an Epic instance. This date represents the internal concept of Triage History Instant, for the forwarding decision done at the external organization.
16 | EMSG_COMM_PAT_ENC_CSN_ID | NUMERIC | No |
This item is part of a link to a communication from which the referral was created. This item contains the CSN of the contact which contains the communication. EMSG_COMM_JOB_ID (I RFL 18961) contains the communication job ID.
17 | EMSG_COMM_JOB_ID | VARCHAR | No |
Part of a link to a communication from which the referral was created.
18 | AUTHORIZED_MEDICATION_ID_MEDICATION_NAME | VARCHAR | No |
The name of this medication record.
19 | INITIAL_REQUEST_TYPE_C_NAME | VARCHAR | No |
The initial request type for the referral.
May contain organization-specific values: No
Category Entries:
Preservice
Retro
Concurrent
20 | REF_BY_CNTRCT_AT_AUTH_YN | VARCHAR | No |
The contracted status of referred-by entities on the referral as of the last decision or the current contracted status if the referral is pending.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
21 | REF_TO_CNTRCT_AT_AUTH_YN | VARCHAR | No |
The contracted status of referred-to entities on the referral as of the last decision or the current contracted status if the referral is pending.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
22 | REF_BY_SER_CNTRCT_AT_AUTH_YN | VARCHAR | No |
The contracted status of referred-by provider on the referral as of the last decision or the current contracted status if the referral is pending.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
23 | REF_TO_SER_CNTRCT_AT_AUTH_YN | VARCHAR | No |
The contracted status of referred-to provider on the referral as of the last decision or the current contracted status if the referral is pending.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
24 | REF_BY_EAF_CNTRCT_AT_AUTH_YN | VARCHAR | No |
The contracted status of referred-by location on the referral as of the last decision or the current contracted status if the referral is pending.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
25 | REF_TO_EAF_CNTRCT_AT_AUTH_YN | VARCHAR | No |
The contracted status of referred-to location on the referral as of the last decision or the current contracted status if the referral is pending.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
26 | REF_TO_VEN_CNTRCT_AT_AUTH_YN | VARCHAR | No |
The contracted status of referred-to vendor on the referral as of the last decision or the current contracted status if the referral is pending.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
27 | REF_BY_PROV_NET_LEVEL_C_NAME | VARCHAR | No |
The network status of the referred-by provider on the referral.
May contain organization-specific values: Yes
Category Entries:
In Network
Out of Network
N/A
28 | REF_TO_LOCATION_NET_LEVEL_C_NAME | VARCHAR | No |
The network status of the referred-to location on the referral.
The category values for this column were already listed for column: REF_BY_PROV_NET_LEVEL_C_NAME
29 | REF_TO_VENDOR_NET_LEVEL_C_NAME | VARCHAR | No |
The network status of the referred-to vendor on the referral.
The category values for this column were already listed for column: REF_BY_PROV_NET_LEVEL_C_NAME
30 | REF_TO_PROV_NET_LEVEL_C_NAME | VARCHAR | No |
The network status of the referred-to provider on the referral.
The category values for this column were already listed for column: REF_BY_PROV_NET_LEVEL_C_NAME
31 | REF_BY_LOCATION_NET_LEVEL_C_NAME | VARCHAR | No |
The network status of the referred-by location on the referral.
The category values for this column were already listed for column: REF_BY_PROV_NET_LEVEL_C_NAME
32 | RPT_REF_BY_SER_CNTRCT_YN | VARCHAR | No |
The user override for the contracted status of the referred-by provider on the referral.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
33 | RPT_REF_TO_SER_CNTRCT_YN | VARCHAR | No |
The user override for the contracted status of the referred-to provider on the referral.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
34 | RPT_REF_BY_EAF_CNTRCT_YN | VARCHAR | No |
The user override for the contracted status of the referred-by location on the referral.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
35 | RPT_REF_TO_EAF_CNTRCT_YN | VARCHAR | No |
The user override for the contracted status of the referred-to location on the referral.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
36 | RPT_REF_TO_VEN_CNTRCT_YN | VARCHAR | No |
The user override for the contracted status of the referred-to vendor on the referral.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
37 | RFL_AUTH_PROG_C_NAME | VARCHAR | No |
Authorization Prognosis code associated with a referral
May contain organization-specific values: Yes
38 | PRINCIPAL_DX_DATE | DATETIME | No |
Specifies the diagnois date used for Prinicpal Diagnosis
39 | ADMISSION_SOURCE_C_NAME | VARCHAR | No |
The source from which the paitent is being admitted or referred. Only available in UM referrals.
May contain organization-specific values: Yes
40 | DISCHRG_DISP_C_NAME | VARCHAR | No |
This disposition (location) of the patient after discharge. Only available in UM referrals.
May contain organization-specific values: Yes
41 | FIRST_PAT_ENC_CSN_ID | NUMERIC | No |
Ths CSN of the encounter linked to the referral or auth/cert with the earliest encounter instant.
42 | LAST_PAT_ENC_CSN_ID | NUMERIC | No |
Ths CSN of the encounter linked to the referral or auth/cert with the latest encounter instant.
43 | REF_BY_CNTRCT_AT_DEC_YN | VARCHAR | No |
The contracted status of referred-by entities on the referral as of the last decision.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
44 | REF_TO_CNTRCT_AT_DEC_YN | VARCHAR | No |
The contracted status of referred-to entities on the referral as of the last decision.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
45 | REF_BY_SER_CNTRCT_AT_DEC_YN | VARCHAR | No |
The contracted status of referred-by provider on the referral as of the last decision.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
46 | REF_TO_SER_CNTRCT_AT_DEC_YN | VARCHAR | No |
The contracted status of referred-to provider on the referral as of the last decision.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
47 | REF_BY_LOC_CNTRCT_AT_DEC_YN | VARCHAR | No |
The contracted status of referred-by location on the referral as of the last decision.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
48 | REF_TO_LOC_CNTRCT_AT_DEC_YN | VARCHAR | No |
The contracted status of referred-to location on the referral as of the last decision.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
49 | REF_TO_VEN_CNTRCT_AT_DEC_YN | VARCHAR | No |
The contracted status of referred-to vendor on the referral as of the last decision.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
50 | REGION_ID_LOC_NAME | VARCHAR | No |
The name of the revenue location.
51 | MEDICAL_GROUP_ID_LOC_NAME | VARCHAR | No |
The name of the revenue location.
52 | PRIMARY_CONDITION_GROUPER_ID_GROUPER_NAME | VARCHAR | No |
Record name
53 | PRIMARY_TREATMENT_GROUPER_ID_GROUPER_NAME | VARCHAR | No |
Record name
54 | PRIMARY_SPECIALTY_GROUPER_ID_GROUPER_NAME | VARCHAR | No |
Record name
55 | PRIMARY_SUBSPEC_GROUPER_ID_GROUPER_NAME | VARCHAR | No |
Record name
56 | CONC_UM_REV_TRANS_FROM_DELE_YN | VARCHAR | No |
Indicates if the responsiblity for concurrent review of this authorization request has been transitioned from a delegate system to this UM system.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
57 | MED_ESTIMATE_CSN_ID | NUMERIC | No |
This item holds the contact serial number (CSN) of the medication estimate (LME) that was linked to the associated order when this referral was created. This item is not populated for renewals.
58 | CLM_NET_OVRIDE_STAT_C_NAME | VARCHAR | No |
The network status to override to when adjudicating the linked claim.
May contain organization-specific values: No
Category Entries:
None
In Network
Out of Network
59 | CLM_NET_OVRIDE_LVL_C_NAME | VARCHAR | No |
The network level to override to when adjudicating the linked claim.
May contain organization-specific values: Yes
Category Entries:
In Network - Not Leveled
60 | CLM_NET_OVRIDE_RSN_C_NAME | VARCHAR | No |
The reason for override a linked claim's adjudication network.
May contain organization-specific values: Yes
61 | UM_AUTH_SERVICE_TYPE_C_NAME | VARCHAR | No |
Service type for Utilization Management (UM) workflows. This is set automatically for UM referrals in Referral Entry after the UM service type is ready for use.
May contain organization-specific values: Yes
No Entries Defined
62 | UM_AUTH_CARE_SETTING_C_NAME | VARCHAR | No |
Care setting for Utilization Management (UM) workflows. This is set automatically for UM referrals in Referral Entry after the UM service type is ready for use.
May contain organization-specific values: No
Category Entries:
Inpatient
Outpatient
Home Health
Hospice