REFERRAL_PX

Description: |
This table contains information on procedures associated with referrals. This table is related to the REFERRAL_ORDER_ID table. The REFERRAL_ORDER_ID table contains the list of procedures for the referral. The REFERRAL_PX table contains information on each of those procedures.

Primary Key

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

Column Information

| Name | Type | Discontinued? |
--- | --- | --- | --- | ---
1 | REFERRAL_ID | NUMERIC | No |
The unique ID of the referral in database.
2 | LINE | INTEGER | No |
The line number of the procedure associated with the referral. For example, if a referral has two associated procedures, the first procedure will have a line value of 1, while the second procedure will have a line value of 2.
3 | PX_ID_PROC_NAME | VARCHAR | No |
The name of each procedure.
4 | UNITS_REQUESTED | INTEGER | No |
The number of units of this procedure that were requested
5 | UNITS_APPROVED | INTEGER | No |
The number of units of this procedure that were approved
6 | TOTAL_PRICE | NUMERIC | No |
The total price calculated for this procedure using fee schedules or vendor contracts (for outgoing referrals)
7 | NET_PAYABLE | NUMERIC | No |
The total net payable calculated for this procedure (the price - the patient portion).
8 | PATIENT_PORTION | NUMERIC | No |
The total patient responsibility calculated for this procedure using the benefits engine
9 | PROV_ID_PROV_NAME | VARCHAR | No |
The name of the service provider. This item may be hidden in a public view of the CLARITY_SER table.
10 | AUTH_REQ_YN | VARCHAR | No |
A flag that indicates whether the member's benefits require a referral for this service. Yes=> a referral is required, No=> a referral is not required.
11 | COVERED | VARCHAR | No |
A flag that indicates whether the procedure is not covered by the member's benefits or it is covered but by supplemental insurance
12 | REVENUE_CODE_ID | NUMERIC | No |
Stores the revenue billing code entered on the service.