MED_PA_DETAILS
Description:
This table holds the history of electronic prior authorization interactions.

Primary Key
Column Name Ordinal Position
REFERRAL_ID 1
LINE 2

Column Information
Name Type Discontinued?
1 REFERRAL_ID NUMERIC No
The unique identifier for the referral 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 EPA_STATUS_C_NAME VARCHAR No
This item holds the status of the electronic prior authorization request.
May contain organization-specific values: No
Category Entries:
Request sent
Open
Closed
Denied
Appeal sent
Appeal open
Appeal denied
Appeal closed
Canceled
Waiting for manual response
Change payer
Approved
Appeal approved
Error
In Process
4 PAYER_ORG_ID NUMERIC No
This item holds the payer the electronic prior authorization request was sent to.
5 PAYER_ORG_ID_EXTERNAL_NAME VARCHAR No
Organization's external name used as the display name on forms and user interfaces.
6 PA_CASE_ID VARCHAR No
This item holds the electronic prior authorization case ID. It is generated by the payer for tracking the electronic prior authorization transaction in their internal system. This value will not change during an electronic prior authorization interaction unless the payer is changed.
7 PA_APPEAL_CASE_ID VARCHAR No
This item holds the electronic prior authorization appeal case ID. It is generated by the payer for tracking the electronic prior authorization appeal transaction in their internal system. This value will not change during an electronic prior authorization interaction unless the payer is changed.
8 ACTION_RECVD_DTTM DATETIME (UTC) No
This item holds the instant that the electronic prior authorization action was received.
9 ACTION_SENT_DTTM DATETIME (UTC) No
This item holds the instant that the electronic prior authorization action response was sent.
10 CANCEL_RSN_ID NUMERIC No
This item holds the reason that the electronic prior authorization request was canceled.
11 CANCEL_RSN_ID_EXT_CODE_LST_NAME VARCHAR No
The name of the list value.
12 E_APPEAL_SUPPORT_YN VARCHAR No
This item indicates if the payer supports receiving an electronic appeal.
May contain organization-specific values: No
Category Entries:
No
Yes
13 QUESN_START_LINE INTEGER No
This item holds the line number of the first question associated with this electronic prior authorization action. The actual questions are stored in referral file (RFL) related group 9300.
14 REPLY_DEADLINE_DT DATETIME No
This item holds the deadline for replying to the electronic prior authorization questions.
15 QUESN_SET_TITLE VARCHAR No
This item holds the question set title.
16 QUESN_PHONE_NUM VARCHAR No
This item holds the phone number for the electronic prior authorization question set.
17 QUESN_END_LINE INTEGER No
This item holds the line number of the last question associated with this electronic prior authorization action. The actual questions are stored in referral file (RFL) related group 9300.
18 PA_CANCEL_RSLT_C_NAME VARCHAR No
This item holds the result of a request to cancel an ePA request.
May contain organization-specific values: No
Category Entries:
Approved
Denied
19 PA_CNCL_RSLT_RSN_ID NUMERIC No
This holds the code indicating why a cancel request was denied.
20 PA_CNCL_RSLT_RSN_ID_EXT_CODE_LST_NAME VARCHAR No
The name of the list value.
21 QUESN_SET_ID VARCHAR No
This item holds the ID of an electronic prior authorization question set.
22 SEND_USER_ID VARCHAR No
This item holds the user ID of the last user who performed an action that populated the ePA Action Instant Sent item I RFL 9206.
23 SEND_USER_ID_NAME VARCHAR No
The name of the user record. This name may be hidden.
24 QUESN_FAX_NUM VARCHAR No
This item holds the fax number for the electronic prior authorization question set
25 EPA_REPLY_TM DATETIME (UTC) No
Holds the time component of the deadline to reply, if available.
26 EPA_RELATES_MSG VARCHAR No
This holds the message ID that ePA closed responses are related to.
27 EPA_CLSED_RSP_SRC_C_NAME VARCHAR No
This holds the type of closed response that is stored on this line of data.
May contain organization-specific values: No
Category Entries:
PBM
3rd Party
Network
28 EPA_FORM_URL VARCHAR No
This holds the URL pointing to a form to enter PA details.
29 ATTACHMENT_REQ_YN VARCHAR No
This item indicates whether an attachment is required as part of filling out this question set.
The category values for this column were already listed for column: E_APPEAL_SUPPORT_YN
30 EXPECT_RESP_DATE DATETIME No
This item holds the date by which a response is expected from the payer.
31 EPA_BEN_INFO_MESSAGE_ID NUMERIC No
This item holds the ID of the interface message that holds coordination of benefits information that applies to this prior authorization request.
32 EPA_ATTACHMENT_ID VARCHAR No
This item holds the DCS record representing an ePA attachment.