CAP_DTL_TX

Description: |
The CAP_DTL_TX table contains capitation detailed transactions associated with received capitation files.

Primary Key

Column Name | Ordinal Position |
--- | --- | ---
TRANSACTION_ID | 1 |

Column Information

| Name | Type | Discontinued? |
--- | --- | --- | --- | ---
1 | TRANSACTION_ID | VARCHAR | No |
The unique identifier (.1 item) for the detail transaction record.
2 | AR_TX_TYPE_C_NAME | VARCHAR | No |
The type of transaction. This indicates if the transaction is a charge, a payment, or an adjustment.
May contain organization-specific values: No
Category Entries:
Charge
Payment
Debit Adjustment
Credit Adjustment
3 | AR_TX_CODE_PROC_ID_PROC_NAME | VARCHAR | No |
The name of each procedure.
4 | AR_TX_AMOUNT | NUMERIC | No |
The dollar amount for a transaction.
5 | AR_TX_CAP_CNTRCT_ACCT_ID | VARCHAR | No |
The account that this transaction is posting to.
6 | AR_TX_COVERAGE_ID | NUMERIC | No |
The coverage that this transaction applies to.
7 | AR_TX_EFF_DATE | DATETIME | No |
The effective date that this transaction applies to.
8 | AR_MEMBER_PAT_ID | VARCHAR | No |
The member that this transaction applies to. This applies only to per-member accounts.
9 | AR_SUBSCRIBER_PAT_ID | VARCHAR | No |
The subscriber that this transaction applies to.
10 | AR_TX_STATUS_C_NAME | VARCHAR | No |
The current status for a transaction.
May contain organization-specific values: No
Category Entries:
New
Waiting to file
Filing
In Review
Filed
Voided
11 | AR_TX_FILED_DATE | DATETIME | No |
The date that a transaction has filed to the system.
12 | AR_TX_REVERSAL_ID | VARCHAR | No |
The transaction ID that is being reversed by a given transaction.
13 | AR_TX_CORRECTED_ID | VARCHAR | No |
The transaction ID that is being corrected by a given transaction.
14 | CAP_TX_SUBTYPE_C_NAME | VARCHAR | No |
Stores the subtype of the capitation transaction. Used to distinguish between different types of capitation payments made to a single account in the same month.
May contain organization-specific values: No
Category Entries:
Part A
Part B
Part D
15 | CAP_TX_ADJ_RSN_C_NAME | VARCHAR | No |
Stores the adjustment reason code for the capitation transaction.
May contain organization-specific values: No
Category Entries:
Prospective Payment Components
Notification of Death of Beneficiary
Retroactive Enrollment
Retroactive Disenrollment
Correction to Enrollment Date
Correction to Disenrollment Date
Correction to Part A Entitlement
Retroactive Hospice Status
Retroactive ESRD
Retroactive Institutional Status
Retroactive Medicaid Status
Retroactive Change to State County Code
Date of Death Correction
Date of Birth Correction
Correction to Sex Code
For APPS use only
Part C Rate Change
Correction to Part B Entitlement
Retroactive Working Aged Status
Retroactive NHC Status
Disenrolled Due to Prior ESRD
Demo Factor Adjustment
Part C Risk Adjustment Factor Change/Recon
Mid-year Part C Risk Adjustment Factor Change
Retroactive Change to Congestive Heart Failure (CHF) Payment
Retroactive Change to BIPA Part B Premium Reduction Amount
Retroactive Change to Hospice Rate
Retroactive Change to Basic Part D Premium
Retroactive Change to Part D Low Income Status
Retroactive Change to Estimated Cost-Sharing Amount
Retroactive Change to Estimated Reinsurance Amount
Retroactive Change to Basic Part C Premium
Retroactive Change to Rebate Amount
Part D Rate Change
Part D Risk Adjustment Factor Change
Part C Segment ID Changes
Part D Risk Adjustment Factor (ongoing)
Retroactive MSP Status
Retroactive correction of previously failed Payment (affects Part C and D)
Disenroll for Failure to Pay Part D IRMAA Premium - Reported for Pt C and Pt D
Correction of Part D Eligibility - Reported for Pt D
Payment adjustment due to Beneficiary Merge
Part C Payment Adjustments created as a result of the RAS overpayment file processing
Part D Payment Adjustments created as a result of the RAS overpayment file processing
Confirmed Incarceration - Reported for Pt C and Pt D
Not Lawfully Present
System of Record History Alignment
Special Payment Adjustment Due to Cleanup
16 | CAP_TX_PMT_DATE | DATETIME | No |
Stores the date of the captiation payment