AP_CLAIM_2
Description:
The AP_CLAIM_2 table contains one record for each claim in Tapestry's Accounts Payable module.

Primary Key
Column Name Ordinal Position
CLAIM_ID 1

Column Information
Name Type Discontinued?
1 CLAIM_ID NUMERIC No
The unique identifier for the claim record.
2 E_CODE_POA_C_NAME VARCHAR No
Present on Admission (POA) indicator for the external cause of injury diagnosis code.
May contain organization-specific values: No
Category Entries:
1 - Unreported/Not used
Y - Yes
N - No
U - Unknown
W - Clinically undetermined
3 READY_FOR_AP_MGR_ID_MEM_GRP_NAME VARCHAR No
The name of the member group
4 TOT_REFD_RECVD NUMERIC No
The total refund received for the claim.
5 TOTAL_COB_AMOUNT NUMERIC No
Contains the calculated Coordination of Benefits (COB) amount for all services on the claim.
6 EPSDT_YN VARCHAR No
Stores if an Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) referral was given to the patient on the claim.
May contain organization-specific values: No
Category Entries:
No
Yes
7 RENDERING_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.
8 TOTAL_MOB_AMOUNT NUMERIC No
Stores the total Maintenance of Benefits (MOB) amount for all services on the claim.
9 PMT_INFO_MAP_LN INTEGER No
Stores the line that the Tapestry Profile responsibility map matched on.
10 PMT_INFO_GRPR_ID VARCHAR No
Stores the grouper rule that the Tapestry Profile responsibility map matched on.
11 PMT_INFO_GRPR_ID_RULE_NAME VARCHAR No
The name of the rule.
12 PMT_INFO_RULE_ID VARCHAR No
Stores the rule that the Tapestry Profile responsibility map matched on.
13 PMT_INFO_RULE_ID_RULE_NAME VARCHAR No
The name of the rule.
14 PMT_INFO_SPLIT_ID NUMERIC No
Stores the split definition record that was determined by the Tapestry Profile responsibility map.
15 PMT_INFO_SPLIT_ID_SPLIT_DEF_NAME VARCHAR No
The name of the split definition record.
16 SPECIALTY_SOURCE_C_NAME VARCHAR No
Source of associated specialty.
May contain organization-specific values: No
Category Entries:
Vendor
Physician
User
Provider Taxonomy Code
Vendor Taxonomy Code
Provider Specialty Table
Profile Specialty Table
17 CASE_MGMT_CREAT_ID VARCHAR No
ID of the case trigger message associated with the claim.
18 CVG_FILTER_EPP_ID_BENEFIT_PLAN_NAME VARCHAR No
The name of the benefit plan record.
19 PMT_INFO_STOP_COND INTEGER No
Stores the procedure line that triggered a stopping condition during pricing.
20 NO_MEM_GRP_YN VARCHAR No
Identifies that the claim does not have a member group.
May contain organization-specific values: No
Category Entries:
No
Yes
21 INTEREST_TOTAL NUMERIC No
Stores the total interest for the claim, from the constituent service lines.
22 PROV_ACPT_ASGN_C_NAME VARCHAR No
Stores the provider accept assignment code.
May contain organization-specific values: No
Category Entries:
A - Assigned
B - Assigned for Clinical Lab Services Only
C - Not Assigned
P - Patient Refused to Assign Benefits
23 BEN_ASGN_IND_C_NAME VARCHAR No
Stores the benefits assignment indicator.
May contain organization-specific values: No
Category Entries:
N - No
Y - Yes
W - Not Applicable
24 OVRD_SUB_POLICY_YN VARCHAR No
If this item is set, the submission policy tables at the profile and on the vendor contract are ignored. The Claim filing window (days) setting on the vendor contract is also ignored.
The category values for this column were already listed for column: NO_MEM_GRP_YN
25 OVRD_SUB_POL_RSN_C_NAME VARCHAR No
This item provides an explanation as to why the override submission policy item is set.
May contain organization-specific values: Yes
No Entries Defined
26 CLM_TRAIT_1_C_NAME VARCHAR No
The first custom claim trait, used to classify and group claims.
May contain organization-specific values: Yes
27 CLM_TRAIT_2_C_NAME VARCHAR No
The second custom claim trait, used to classify and group claims.
May contain organization-specific values: Yes
28 CLM_TRAIT_3_C_NAME VARCHAR No
The third custom claim trait, used to classify and group claims.
May contain organization-specific values: Yes
No Entries Defined
29 CLM_TRAIT_4_C_NAME VARCHAR No
The fourth custom claim trait, used to classify and group claims.
May contain organization-specific values: Yes
No Entries Defined
30 CLM_TRAIT_5_C_NAME VARCHAR No
The fifth custom claim trait, used to classify and group claims.
May contain organization-specific values: Yes
No Entries Defined
31 TP_INFO_837_SEND_ID NUMERIC No
The trading partner (NTP record) that sent the ANSI 837 claim file that was used to submit this claim.
32 TP_INFO_837_SEND_ID_TRADING_PARTNR_NAME VARCHAR No
The name of the trading partner record.
33 TP_INFO_837_RCVR_ID NUMERIC No
The trading partner (NTP record) that received the ANSI 837 claim file that was used to submit this claim.
34 TP_INFO_837_RCVR_ID_TRADING_PARTNR_NAME VARCHAR No
The name of the trading partner record.
35 APPLIANCE_PLACE_DT DATETIME No
This is the date orthodontic appliances were placed.
36 DNTL_SVC_FROM_DT DATETIME No
This is the dental service span from date.
37 DNTL_SVC_TO_DT DATETIME No
This is the dental service span to date.
38 ORTHO_SVCS_YN VARCHAR No
This is to determine if orthodontic services were performed.
The category values for this column were already listed for column: NO_MEM_GRP_YN
39 ORTHO_TOT_MONTHS INTEGER No
This is the total months of orthodontic treatment.
40 ORTHO_MNTHS_REMAIN INTEGER No
This is the months of orthodontic treatment remaining
41 ASSIST_SURGEON_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.
42 DENTAL_INFO_YN VARCHAR No
This is to determine if the claim has dental information.
The category values for this column were already listed for column: NO_MEM_GRP_YN
43 LMP_DATE DATETIME No
The date of the patient's last menstrual period.
44 CHIR_FRST_TRT_DT DATETIME No
First treatment date listed on the patient's claim.
45 FROM_OCR_YN VARCHAR No
Flags whether the claim was originally paper or scanned into the system through an EDI batch load.
The category values for this column were already listed for column: NO_MEM_GRP_YN
46 CLM_PRICER_IDENT_C_NAME VARCHAR No
When a matching repricer organization is found, the identification is stored on the claim.
May contain organization-specific values: Yes
47 TOTAL_HRA_AMOUNT NUMERIC No
Stores the total reimbursement amount for all services on the claim.
48 ORIG_ACT_ADJ_CLM_ID NUMERIC No
The original claim ID of the actual adjustment claim.
49 REF_CLM VARCHAR No
Contains the reference claim ID in the ANSI 837 file from Loop 2300, Segment REF02 with identifier F8. This is often used in combination with the claim frequency code. When the claim frequency code indicates the claim needs to be adjusted or voided, the reference claim ID is used to help identify the claim.
50 MGR_ASSOC_EXT_VAL_C_NAME VARCHAR No
Stores the association extension value returned by the association extension on the member group.
May contain organization-specific values: Yes
51 AMBU_TRAN_REASON_C_NAME VARCHAR No
Transport Reason code for ANSI claims.
May contain organization-specific values: Yes
Category Entries:
Nearest Facility for Care of Symptoms, Complaints, or Both
For the Benefit of a Preferred Physician
For the Nearness of Family Members
For the Care of a Specialist or for Availability of Specialized Equipment
Rehabilitation Facility
52 AMBU_TRAN_DIST NUMERIC No
Transport distance for the CRC segment in the 2300 loop on ANSI claims.
53 AMBU_TXPORT_WT NUMERIC No
Weight of the patient at the time of transport in an ambulance.
54 AMBU_COND_YN VARCHAR No
Indicates a yes or a no condition response code in the related item.
The category values for this column were already listed for column: NO_MEM_GRP_YN
55 AMBU_PICK_UP_CITY VARCHAR No
Stores the city of the ambulance pick-up location.
56 AMBU_PICK_UP_ST_C_NAME VARCHAR No
Stores the state of the ambulance pick-up location.
May contain organization-specific values: Yes
57 AMBU_PICK_UP_ZIP VARCHAR No
Stores the ZIP code of the ambulance pick-up location.
58 AMBU_DROP_OFF_CITY VARCHAR No
Stores the city of the ambulance drop-off location.
59 AMBU_DROP_OFF_ST_C_NAME VARCHAR No
Stores the state of the ambulance drop-off location.
The category values for this column were already listed for column: AMBU_PICK_UP_ST_C_NAME
60 AMBU_DROP_OFF_ZIP VARCHAR No
Stores the ZIP code of the ambulance drop-off location.
61 AMBU_DROP_OFF_NM VARCHAR No
Stores the last name or organization name of the ambulance drop-off location.
62 PAYEE_C_NAME VARCHAR No
Payee of the claim.
May contain organization-specific values: No
Category Entries:
Subscriber
Vendor
Member
Third Party
63 ESRD_ONSET_DATE DATETIME No
This item stores the onset date of End Stage Renal Disease. This date is sent on CMS 2728 form in Field 24.
64 PAYOR_SEQ_NUMBER_C_NAME VARCHAR No
Sequence number of the payor of the claim.
May contain organization-specific values: No
Category Entries:
Primary
Secondary
Tertiary
Quaternary
Quinary
Senary
Septenary
Octonary
Nonary
Denary
Undenary
65 CLM_FREQ_CODE_C_NAME VARCHAR No
Contains the claim frequency type code from the ANSI 837 file. The value comes from Loop 2300, Segment CLM05, Piece 3.
May contain organization-specific values: Yes
66 DENY_CLM_SRC_C_NAME VARCHAR No
Tracks the source of an attempt to deny a claim that can't be immediately denied, but has not yet reached a status of fully paid to be able to be reversed and adjusted. When claims with this item set are removed from a batch or become fully paid, they can be denied or reversed, adjusted and denied.
May contain organization-specific values: No
Category Entries:
Cancel 837