|
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 |
|
|