ATB_AUTH_GENERAL_DETAILS

Description:

This table contains information pertaining to the auth request details.

Primary Key

Column Name	Ordinal Position
AUTH_BUNDLE_ID	1

Column Information

	Name	Type	Discontinued?
1	AUTH_BUNDLE_ID	NUMERIC	No
	The unique identifier (.1 item) for the auth bundle record.
2	AUTH_PAYER_DCSN_C_NAME	VARCHAR	No
	The Payer Decision category ID for the Auth Bundle's payer decision information. May contain organization-specific values: No Category Entries: Authorized No Auth Required Partially Authorized Denied Pending Withdrawn Dismissed by Payer
3	AUTH_PYR_PEND_REASON_C_NAME	VARCHAR	No
	The Auth Payer Pending Reason category ID for the Auth Bundle's payer decision information. Only relevant when the payer decision is pending. May contain organization-specific values: No Category Entries: Clinicals Requested Coverage Verification Needed System Automatically Pend Potential Duplicate Referral Referral Network Review Does Not Pass Benefit Check Needs Medical Review Payer Response Needs Review Created from DMS Needs Peer to Peer Clinicals Sent Authorization Initiated Clinicals Received Additional Visits Needed Medical Director Denied Concurrent Review Not Enough Information Covered by Pharmacy Benefit Request Needs Review Waiting on Payer
4	AUTH_PYR_DENIAL_REASON_C_NAME	VARCHAR	No
	The Auth Payer Denial Reason category ID for the Auth Bundle's payer decision information. Only relevant when the payer decision is denied. May contain organization-specific values: No Category Entries: Not Medically Necessary Retroactive Referral Request Not a Covered Benefit Not in Network Duplicate Referral Request System Automatically Denied Does Not Meet 3rd Party Guidelines DOES NOT MEET INTERNAL GUIDELINES Member not covered Authorized Quantity Exceeded Exceeds Plan Maximums No Prior Approval Requested Information Not Received Service Inconsistent With Diagnosis Pre-Existing Condition Patient is Restricted to Specific Provider Plan/Contractual Guidelines Not Followed Plan/Contractual Geographic Restriction Inappropriate Facility Type Once in a Lifetime Restriction Applies Transport Request Denied Errors in the Request Excluded Benefit Appeal Denied Not Primary Care Physician Level of Care Not Appropriate Denial Response Needs Review Requires Medical Review Experimental Service or Procedure Peer to Peer Needed Time Limits not Met
5	AUTH_PYR_CANCEL_RSN_C_NAME	VARCHAR	No
	The Auth Payer Cancel Reason category ID for the Auth Bundle's payer decision information. Only relevant when the payer decision is cancelled. May contain organization-specific values: No No Entries Defined
6	AUTH_PA_REQ_TYPE_C_NAME	VARCHAR	No
	The Request Type category ID for the Auth Bundle's authorization request information. May contain organization-specific values: No Category Entries: Admission Review Specialty Care Review Health Services Review Individual
7	AUTH_SVC_TYPE_CODE_C_NAME	VARCHAR	No
	The Service Type category ID for the Auth Bundle's authorization request information. May contain organization-specific values: No Category Entries: Medical Care Surgical Consultation Diagnostic X-Ray Diagnostic Lab Radiation Therapy Anesthesia Surgical Assistance Other Medical Blood Charges Used Durable Medical Equipment Durable Medical Equipment Purchase Ambulatory Service Center Facility Renal Supplies in the Home Alternate Method Dialysis Chronic Renal Disease (CRD) Equipment Pre-Admission Testing Durable Medical Equipment Rental Pneumonia Vaccine Second Surgical Opinion Third Surgical Opinion Social Work Diagnostic Dental Periodontics Restorative Endodontics Maxillofacial Prosthetics Adjunctive Dental Services Health Benefit Plan Coverage Plan Waiting Period Chiropractic Chiropractic Office Visits Dental Care Dental Crowns Dental Accident Orthodontics Prosthodontics Oral Surgery Routine (Preventive) Dental Home Health Care Home Health Prescriptions Home Health Visits Hospice Respite Care Hospital Hospital - Inpatient Hospital - Room and Board Hospital - Outpatient Hospital - Emergency Accident Hospital - Emergency Medical Hospital - Ambulatory Surgical Long Term Care Major Medical Medically Related Transportation Air Transportation Cabulance Licensed Ambulance General Benefits In-vitro Fertilization MRI/CAT Scan Donor Procedures Acupuncture Newborn Care Pathology Smoking Cessation Well Baby Care Maternity Transplants Audiology Exam Inhalation Therapy Diagnostic Medical Private Duty Nursing Prosthetic Device Dialysis Otological Exam Chemotherapy Allergy Testing Immunizations Routine Physical Family Planning Infertility Abortion AIDS Emergency Services Cancer Pharmacy Free Standing Prescription Drug Mail Order Prescription Drug Brand Name Prescription Drug Generic Prescription Drug Podiatry Podiatry - Office Visits Podiatry - Nursing Home Visits Professional (Physician) Anesthesiologist Professional (Physician) Visit - Office Professional (Physician) Visit - Inpatient Professional (Physician) Visit - Outpatient Professional (Physician) Visit - Nursing Home Professional (Physician) Visit - Skilled Nursing Facility Professional (Physician) Visit - Home Psychiatric Psychiatric - Room and Board Psychotherapy Psychiatric - Inpatient Psychiatric - Outpatient Rehabilitation Rehabilitation - Room and Board Rehabilitation - Inpatient Rehabilitation - Outpatient Occupational Therapy Physical Medicine Speech Therapy Skilled Nursing Care Skilled Nursing Care - Room and Board Substance Abuse Alcoholism Drug Addiction Vision (Optometry) Frames Routine Exam Lenses Nonmedically Necessary Physical Experimental Drug Therapy Burn Care Brand Name Prescription Drug - Formulary Brand Name Prescription Drug - Non-Formulary Independent Medical Evaluation Partial Hospitalization (Psychiatric) Day Care (Psychiatric) Cognitive Therapy Massage Therapy Pulmonary Rehabilitation Cardiac Rehabilitation Pediatric Nursery Skin Orthopedic Cardiac Lymphatic Gastrointestinal Endocrine Neurology Eye Invasive Procedures Gynecological Obstetrical Obstetrical/Gynecological Mail Order Prescription Drug: Brand Name Mail Order Prescription Drug: Generic Physician Visit - Office: Sick Physician Visit - Office: Well Coronary Care Private Duty Nursing - Inpatient Private Duty Nursing - Home Surgical Benefits - Professional (Physician) Surgical Benefits - Facility Mental Health Provider - Inpatient Mental Health Provider - Outpatient Mental Health Facility - Inpatient Mental Health Facility - Outpatient Substance Abuse Facility - Inpatient Substance Abuse Facility - Outpatient Screening X-ray Screening laboratory Mammogram, High Risk Patient Mammogram, Low Risk Patient Flu Vaccination Eyewear and Eyewear Accessories Case Management Dermatology Durable Medical Equipment Diabetic Supplies Generic Prescription Drug - Formulary Generic Prescription Drug - Non-Formulary Allergy Intensive Care Mental Health Neonatal Intensive Care Oncology Physical Therapy Pulmonary Renal Residential Psychiatric Treatment Transitional Care Transitional Nursery Care Urgent Care
8	AUTH_PA_PRIORITY_C_NAME	VARCHAR	No
	The Auth Priority category ID for the Auth Bundle's authorization request information. May contain organization-specific values: No Category Entries: Routine Urgent Emergency Elective
9	AUTH_START_DATE	DATETIME	No
	The date when the Auth Bundle's authorization starts.
10	AUTH_END_DATE	DATETIME	No
	The date when the Auth Bundle's authorization ends.
11	AUTH_ADMISSION_TYPE_C_NAME	VARCHAR	No
	The Admission Type category ID for the Auth Bundle's authorization request information. May contain organization-specific values: Yes
12	AUTH_ADMISSION_SOURCE_C_NAME	VARCHAR	No
	The Admission Source category ID for the Auth Bundle's authorization request information. May contain organization-specific values: Yes
13	AUTH_PAT_STATUS_C_NAME	VARCHAR	No
	The Patient Status category ID for the Auth Bundle's authorization request information. May contain organization-specific values: Yes
14	AUTH_POS_TYPE_C_NAME	VARCHAR	No
	The POS Type category ID for the Auth Bundle's authorization request information. May contain organization-specific values: Yes Category Entries: Telehealth - Provided in Patient's Home Office Home Assisted Living Facility Group Home Mobile Unit Temporary Lodging Walk-in Retail Health Clinic Place of Employment - Worksite Off Campus - Outpatient Hospital Urgent Care Facility Inpatient Hospital On Campus - Outpatient Hospital Emergency Room - Hospital Ambulatory Surgical Center Birthing Center Military Treatment Facility Outreach Site/Street Skilled Nursing Facility Nursing Facility Custodial Care Facility Hospice Adult Living Care Facility Ambulance - Land Ambulance - Air or Water Independent Clinic Federally Qualified Health Center Inpatient Psychiatric Facility Psychiatric Facility - Partial Hospitalization Community Mental Health Center Intermediate Care Facility/ Individuals with Intellectual Disabilities Residential Substance Abuse Treatment Facility Psychiatric Residential Treatment Center Non-residential Substance Abuse Treatment Facility Non-residential Opioid Treatment Facility Mass Immunization Center Comprehensive Inpatient Rehabilitation Facility Comprehensive Outpatient Rehabilitation Facility End-Stage Renal Disease Treatment Facility Programs of All-Inclusive Care for the Elderly (PACE) Center Public Health Clinic Rural Health Clinic Independent Laboratory Other Place of Service Pharmacy Telehealth - Provided Other than in Patient's Home School Homeless Shelter Indian Health Service Free-standing Facility Indian Health Service Provider-based Facility Tribal 638 Free-standing Facility Tribal 638 Provider-based Facility Prison/Correctional Facility
15	AUTH_PA_UB_TYPE_OF_FAC_C_NAME	VARCHAR	No
	The UB Type of Facility category ID for the Auth Bundle's authorization request information. May contain organization-specific values: No Category Entries: Hospital Skilled Nursing Home Health Religious Non-Medical Health Care Institutions Christian Science (Extended Care) Intermediate Care Clinic - Rural Health Clinic - Hospital Based or Independent Renal Dialysis Center Clinic - Free Standing Clinic - Outpatient Rehabilitation Facility Clinic - Comprehensive Outpatient Rehabilitation Facility Clinic - Community Mental Health Center Clinic - Federally Qualified Health Center Licensed Freestanding Emergency Medical Facility Clinic - Other Hospice (non-hospital based) Hospice (hospital based) Ambulatory Surgery Center Free Standing Birthing Center Critical Access Hospital Residential Facility Freestanding Non-residential Opioid Treatment Facility Special Facility - Other
16	AUTH_UB_BILL_CLASS_C_NAME	VARCHAR	No
	The UB Type of Bill category ID for the Auth Bundle's authorization request information. May contain organization-specific values: No Category Entries: Inpatient (Including Medicare Part A) Inpatient (Medicare Part B only) Outpatient Laboratory Services Provided to Non-patients Intermediate Care - Level I Intermediate Care - Level II Subacute Inpatient (discontinued 10/1/2005) Swing Beds
17	AUTH_CONTACT_NAME	VARCHAR	No
	The name of the contact person to ask for information about this authorization request.
18	AUTH_CONTACT_PHONE	VARCHAR	No
	The phone number of the contact person to ask for information about this authorization request.
19	AUTH_CONTACT_FAX	VARCHAR	No
	The fax number of the contact person to ask for information about this authorization request.
20	AUTH_CONTACT_EMAIL	VARCHAR	No
	The email of the contact person to ask for information about this authorization request.
21	AUTH_REQUESTER_PNTR	VARCHAR	No
	A pointer to the reference ID number used in the entities table to specify which entity is considered the requester.
22	AUTH_ADMSN_START_DATE	DATETIME	No
	The date when the auth bundle request information starts as it pertains to an admission.
23	AUTH_ADMSN_END_DATE	DATETIME	No
	The date when the auth bundle request information ends as it pertains to an admission.
24	AUTH_DISCHARGE_DATE	DATETIME	No
	The date when the auth bundle request information ends as it pertains to a discharge.
25	AUTH_REFERENCE_NUM	VARCHAR	No
	The reference number for the authorization as provided by the payer.
26	AUTH_NUM	VARCHAR	No
	The authorization number that the payer provided about this particular authorization.