CAP_DTL_TX

Description:

The CAP_DTL_TX table contains capitation detailed transactions associated with received capitation files.

Primary Key

Column Name	Ordinal Position
TRANSACTION_ID	1

Column Information

	Name	Type	Discontinued?
1	TRANSACTION_ID	VARCHAR	No
	The unique identifier (.1 item) for the detail transaction record.
2	AR_TX_TYPE_C_NAME	VARCHAR	No
	The type of transaction. This indicates if the transaction is a charge, a payment, or an adjustment. May contain organization-specific values: No Category Entries: Charge Payment Debit Adjustment Credit Adjustment
3	AR_TX_CODE_PROC_ID_PROC_NAME	VARCHAR	No
	The name of each procedure.
4	AR_TX_AMOUNT	NUMERIC	No
	The dollar amount for a transaction.
5	AR_TX_CAP_CNTRCT_ACCT_ID	VARCHAR	No
	The account that this transaction is posting to.
6	AR_TX_COVERAGE_ID	NUMERIC	No
	The coverage that this transaction applies to.
7	AR_TX_EFF_DATE	DATETIME	No
	The effective date that this transaction applies to.
8	AR_MEMBER_PAT_ID	VARCHAR	No
	The member that this transaction applies to. This applies only to per-member accounts.
9	AR_SUBSCRIBER_PAT_ID	VARCHAR	No
	The subscriber that this transaction applies to.
10	AR_TX_STATUS_C_NAME	VARCHAR	No
	The current status for a transaction. May contain organization-specific values: No Category Entries: New Waiting to file Filing In Review Filed Voided
11	AR_TX_FILED_DATE	DATETIME	No
	The date that a transaction has filed to the system.
12	AR_TX_REVERSAL_ID	VARCHAR	No
	The transaction ID that is being reversed by a given transaction.
13	AR_TX_CORRECTED_ID	VARCHAR	No
	The transaction ID that is being corrected by a given transaction.
14	CAP_TX_SUBTYPE_C_NAME	VARCHAR	No
	Stores the subtype of the capitation transaction. Used to distinguish between different types of capitation payments made to a single account in the same month. May contain organization-specific values: No Category Entries: Part A Part B Part D
15	CAP_TX_ADJ_RSN_C_NAME	VARCHAR	No
	Stores the adjustment reason code for the capitation transaction. May contain organization-specific values: No Category Entries: Prospective Payment Components Notification of Death of Beneficiary Retroactive Enrollment Retroactive Disenrollment Correction to Enrollment Date Correction to Disenrollment Date Correction to Part A Entitlement Retroactive Hospice Status Retroactive ESRD Retroactive Institutional Status Retroactive Medicaid Status Retroactive Change to State County Code Date of Death Correction Date of Birth Correction Correction to Sex Code For APPS use only Part C Rate Change Correction to Part B Entitlement Retroactive Working Aged Status Retroactive NHC Status Disenrolled Due to Prior ESRD Demo Factor Adjustment Part C Risk Adjustment Factor Change/Recon Mid-year Part C Risk Adjustment Factor Change Retroactive Change to Congestive Heart Failure (CHF) Payment Retroactive Change to BIPA Part B Premium Reduction Amount Retroactive Change to Hospice Rate Retroactive Change to Basic Part D Premium Retroactive Change to Part D Low Income Status Retroactive Change to Estimated Cost-Sharing Amount Retroactive Change to Estimated Reinsurance Amount Retroactive Change to Basic Part C Premium Retroactive Change to Rebate Amount Part D Rate Change Part D Risk Adjustment Factor Change Part C Segment ID Changes Part D Risk Adjustment Factor (ongoing) Retroactive MSP Status Retroactive correction of previously failed Payment (affects Part C and D) Disenroll for Failure to Pay Part D IRMAA Premium - Reported for Pt C and Pt D Correction of Part D Eligibility - Reported for Pt D Payment adjustment due to Beneficiary Merge Part C Payment Adjustments created as a result of the RAS overpayment file processing Part D Payment Adjustments created as a result of the RAS overpayment file processing Confirmed Incarceration - Reported for Pt C and Pt D Not Lawfully Present System of Record History Alignment Special Payment Adjustment Due to Cleanup
16	CAP_TX_PMT_DATE	DATETIME	No
	Stores the date of the captiation payment