AP_CLAIM_REVIEW
Description:
The AP_CLAIM_REVIEW table contains a row for each review on a claim.

Primary Key
Column Name Ordinal Position
CLAIM_ID 1
LINE 2

Column Information
Name Type Discontinued?
1 CLAIM_ID NUMERIC No
The unique identifier for the claim info record.
2 LINE INTEGER No
The line number for the information associated with this record. Multiple pieces of information can be associated with this record.
3 AP_CLAIM_REVIEW_TYPE_C_NAME VARCHAR No
The review type category ID for the review on the claim.
May contain organization-specific values: Yes
Category Entries:
High Dollar
Medical Necessity
Random Audit
Recovery Action
Potential Bundle
Appealed
Pre-Pay Audit (External)
Pre-Pay Audit Update (External)
4 ATTACH_COMMENT VARCHAR No
The comment associated with a review when it is attached to a claim.
5 AP_CLAIM_REVIEW_STATUS_C_NAME VARCHAR No
The review status category ID for the review on the claim.
May contain organization-specific values: No
Category Entries:
Under Review
Rejected
Not Applicable
Approved
6 ATTACH_DTTM DATETIME (Local) No
The date and time the associated review was attached to the claim.
7 COMPLETION_COMMENT VARCHAR No
The comment entered by the user who completed the associated review.
8 COMPLETION_DTTM DATETIME (Local) No
The completion date and time for the associated review.
9 REJECTION_EOB_CODE_ID_EOB_CODE_NAME VARCHAR No
The name of the processing code.
10 ADDED_MANUALLY_YN VARCHAR No
Indicates whether this review was added manually by an end user. 'Y' indicates that the review was added manually. 'N' or NULL indicate that the review was added by the system.
May contain organization-specific values: No
Category Entries:
No
Yes
11 REVIEW_STATUS_REASON_C_NAME VARCHAR No
The review status reason category ID for the review on the claim.
May contain organization-specific values: No
Category Entries:
Claim Pending
Rules No Longer Match
Non-Recovery Review Added
Auto-Approve Rule Met
External Action Taken