AP_CLAIM_PROV_RESP

Description:

This table contains the provider responsibility information for AP Claim procedures. To link this table’s service line information back to a claim header, join this table to AP_CLAIM_PROC_IDS on the TX_ID column. If you need to report on claim service lines specific to Cost Sharing Reduction (CSR), join this table instead to AP_CLAIM_PROC_IDS_CSR on the TX_ID column.

Primary Key

Column Name	Ordinal Position
TX_ID	1
LINE	2

Column Information

	Name	Type	Discontinued?
1	TX_ID	NUMERIC	No
	The unique ID of the AP Claim procedure transaction.
2	LINE	INTEGER	No
	The line number of the provider responsibility for this transaction record.
3	PROV_RESP_AMT	NUMERIC	No
	The dollar amount for a specific provider responsibility.
4	PRV_RESP_SRC_TP_C_NAME	VARCHAR	No
	The type of provider responsibility. May contain organization-specific values: No Category Entries: Submission Policy Before Benefit Penalty Denial Via EOB Not Covered By Plan Bundle Adjustment
5	EOB_CODE_ID	NUMERIC	No
	The unique identifier of the EOB code used for denial so that the billed amount was routed to the provider responsibility amount.
6	PROV_RESP_OVRD_AMT	NUMERIC	No
	The user-entered override to the dollar amount a specific provider responsibility. If present, the value in this column overrides the value in PRV_RESP_AMT.