|
Name |
Type |
Discontinued? |
|
| 1 |
TX_ID |
NUMERIC |
No |
|
|
|
| The unique identifier (.1 item) for the transaction record. |
|
|
| 2 |
TX_TYPE_C_NAME |
VARCHAR |
No |
|
|
|
| Stores the type of the adjustment transaction. |
| May contain organization-specific values: No |
| Category Entries: |
| Incoming Receipt |
| PCP Capitation |
| Specialty Capitation |
| AP Claims Adjustment |
| Withhold Adjustment |
| General Adjustment |
| Other Reimbursement |
| PCP Capitation Adjustment |
| Specialty Capitation Adjustment |
| Employer Group Reimbursement |
| Incoming Receipt Adjustment |
| Broker Commission |
| Commission Adjustment |
|
|
| 3 |
TX_STATUS_C_NAME |
VARCHAR |
No |
|
|
|
| The status of the transaction. |
| May contain organization-specific values: No |
| Category Entries: |
| Loaded |
| Reconciled |
| Calculated |
| AP Batched |
| Paid |
| Void |
| New |
| Fully Invoiced |
|
|
| 4 |
SPECIAL_TX_TYPE_C_NAME |
VARCHAR |
No |
|
|
|
| This item stores the transaction type. |
| May contain organization-specific values: Yes |
| Category Entries: |
| Manual |
| Retro |
| AP Claims Holdback |
| Paid By Carrier Claim |
| Withholding Payback |
| COB Savings Member Payout |
| Refund |
| Extra Refund |
| Remittance Recovery |
| Write-off Refund |
| HRA Remittance Recovery |
| Prepayment |
| Future Prepayment |
| Prepayment Recovery |
| Capitation Adjustment Recovery |
|
|
| 5 |
EFFECTIVE_DATE |
DATETIME |
No |
|
|
|
| Contains first of month as the date for which the batch containing this transaction is filed. |
|
|
| 6 |
POSTING_DATE |
DATETIME |
No |
|
|
|
| The date this transaction was posted. |
|
|
| 7 |
ELIGIBILITY_DATE |
DATETIME |
No |
|
|
|
| The eligibility date used to compute this transaction. |
|
|
| 8 |
USER_ID |
VARCHAR |
No |
|
|
|
| The user that created the record |
|
|
| 9 |
USER_ID_NAME |
VARCHAR |
No |
|
|
|
| The name of the user record. This name may be hidden. |
|
|
| 10 |
COMMISSION_PAT_ID |
VARCHAR |
No |
|
|
|
| The member associated with the commission transaction. |
|
|
| 11 |
COMM_PLAN_GRP_ID |
VARCHAR |
No |
|
|
|
| The employer group of the member associated with the commission transaction. |
|
|
| 12 |
COMM_PLAN_GRP_ID_PLAN_GRP_NAME |
VARCHAR |
No |
|
|
|
| The name of the employer group record |
|
|
| 13 |
COMMISSION_CVG_ID |
NUMERIC |
No |
|
|
|
| The coverage associated with the commission transaction. |
|
|
| 14 |
COMMISSION_TML_ID |
NUMERIC |
No |
|
|
|
| The list of members associated with the commission transaction. |
|
|
| 15 |
COMM_BUS_SEG_POS_ID_LOC_NAME |
VARCHAR |
No |
|
|
|
| The name of the revenue location. |
|
|
| 16 |
COMM_BROKER_ID_AGENT_NAME |
VARCHAR |
No |
|
|
|
|
| 17 |
COMM_BROKERAGE_ID |
VARCHAR |
No |
|
|
|
| The brokerage associated with the commission transaction. |
|
|
| 18 |
COMM_BROKERAGE_ID_AGENCY_NAME |
VARCHAR |
No |
|
|
|
|
| 19 |
COMMISSION_TYPE_C_NAME |
VARCHAR |
No |
|
|
|
| The commission type of the transaction. |
| May contain organization-specific values: Yes |
|
|
| 20 |
COMMISSION_LOB_ID |
VARCHAR |
No |
|
|
|
| The line of business of the coverage for the commission transaction. |
|
|
| 21 |
COMMISSION_LOB_ID_LOB_NAME |
VARCHAR |
No |
|
|
|
| The name of the line of business record. |
|
|
| 22 |
COMM_GVT_PRGRM_C_NAME |
VARCHAR |
No |
|
|
|
| The government program type of the coverage for the commission transaction. |
| May contain organization-specific values: No |
| Category Entries: |
| Non-government Program |
| Individual Market |
| SHOP Market |
| Medicare Advantage |
| Prescription Drug (Part D) |
| Medicare Advantage + Prescription Drug |
|
|
| 23 |
COMMISSION_VEN_ID_VENDOR_NAME |
VARCHAR |
No |
|
|
|
|
| 24 |
COMMISSION_GL_CODE |
VARCHAR |
No |
|
|
|
| The GL string for the comission transaction. |
|
|
| 25 |
COMMISSION_RUN_ID |
NUMERIC |
No |
|
|
|
| The computation run record ID for the commission transaction. |
|
|
| 26 |
COMM_FORMULA_ID |
VARCHAR |
No |
|
|
|
| The rate table used to compute the commission transaction. |
|
|
| 27 |
COMM_FORMULA_ID_RATE_TABLE_NAME |
VARCHAR |
No |
|
|
|
| Name of the capitation rate table. |
|
|
| 28 |
COMMISSION_AMT |
NUMERIC |
No |
|
|
|
| The commission amount the broker has earned. |
|
|
| 29 |
COMMISSION_UN_AMT |
NUMERIC |
No |
|
|
|
| The computed commission amount withheld from payment. |
|
|
| 30 |
COMMISSION_WHLD_C_NAME |
VARCHAR |
No |
|
|
|
| The reason the commission was withheld from payment. |
| May contain organization-specific values: No |
| Category Entries: |
| Member Suspended |
| Member Limit Exceeded |
| Rate Element Used Default Value |
| Invalid Broker of Record |
|
|
| 31 |
COMMISSION_ELIG_AMT |
NUMERIC |
No |
|
|
|
| The eligibility portion of the commission. |
|
|
| 32 |
COMMISSION_MGR_ID_MEM_GRP_NAME |
VARCHAR |
No |
|
|
|
| The name of the member group |
|
|
| 33 |
COMM_SCHED_SRC_C_NAME |
VARCHAR |
No |
|
|
|
| The source of the commission schedule. |
| May contain organization-specific values: No |
| Category Entries: |
| Brokerage |
| Employer Group |
| Customer Profile |
|
|