OTH_CVG_INFO
Description:
All values associated with a claim are stored in the Claim External Value record. The OTH_CVG_INFO table holds information about the patient's other coverages that have been or will be billed for the services on the claim.

Primary Key
Column Name Ordinal Position
RECORD_ID 1
LINE 2

Column Information
Name Type Discontinued?
1 RECORD_ID NUMERIC No
The unique identifier for the claim record.
2 LINE INTEGER No
The line number for the information associated with this contact. Multiple pieces of information can be associated with this contact.
3 OTH_CVG_SEQ_CD VARCHAR No
This item holds the code identifying the filing order for the other coverage (primary, secondary, tertiary, etc).
4 OTH_CVG_PAT_MEM_ID VARCHAR No
This item holds the member ID for the patient on the other coverage.
5 OTH_CVG_GRP_NUM VARCHAR No
This item holds the group number entered in the other coverage record.
6 OTH_CVG_GRP_NAM VARCHAR No
This item holds the group name entered in the other coverage record.
7 OTH_CVG_INS_TYP VARCHAR No
This item holds the insurance type code for the other coverage.
8 OTH_CVG_FILING_IND VARCHAR No
This item holds an indicator identifying the type of claim if the claim was submitted to the other coverage.
9 OTH_CVG_AUTH_PMT VARCHAR No
This item holds the indicator that the insured of the other coverage assigns benefits to the provider.
10 OTH_CVG_SIG_SRC VARCHAR No
This item indicates that the release forms were signed on the patient's behalf.
11 OTH_CVG_REL_INFO VARCHAR No
This item holds the indicator that the insured of the other coverage has authorized the release of information to the payer.
12 OTH_CVG_AMT_PAID NUMERIC No
This item holds the amount already paid by the payer of the other coverage.
13 OTH_CVG_PAT_DUE NUMERIC No
This item holds the amount identified by the payer of the other coverage to be the patient's responsibility.
14 OTH_CVG_NON_CVD NUMERIC No
This item holds the amount identified as non-covered by the payer of the other coverage.
15 OTH_PYR_NAM VARCHAR No
This item holds the payer name for the other coverage.
16 OTH_PYR_QUAL VARCHAR No
This item holds a qualifier describing the ID used to identify the other payer.
17 OTH_PYR_ID VARCHAR No
This item holds the ID of the other payer.
18 OTH_PYR_PMT_DT DATETIME No
This item holds the date of the other payer's payment.
19 OTH_PYR_AUTH_NUM VARCHAR No
This item holds the other payer's authorization number.
20 OTH_PYR_RFL_NUM VARCHAR No
This item holds the other payer's referral number.
21 OTH_PYR_ICN VARCHAR No
This item holds the other payer's internal control number (ICN).
22 OTH_PYR_ADDR_1 VARCHAR No
This item holds the first line of the other payer's street address.
23 OTH_PYR_ADDR_2 VARCHAR No
This item holds the second line of the other payer's street address.
24 OTH_PYR_CITY VARCHAR No
This item holds the other payer's city.
25 OTH_PYR_STATE VARCHAR No
This item holds the other payer's state.
26 OTH_PYR_ZIP VARCHAR No
This item holds the other payer's ZIP code.
27 OTH_PYR_CNTRY VARCHAR No
This item holds the other payer's country. It is only populated if the address is outside the United States.
28 OTH_PYR_CNTRY_SUB VARCHAR No
This item holds the other payer's country subdivision (state, province, etc). It is only populated if the address is outside the United States.
29 OTH_CVG_CVD_DAY INTEGER No
This item holds the number of covered days identified on the other coverage's payment.
30 OTH_CVG_PSYCH_DAY INTEGER No
This item holds the number of psychiatric days identified on the other coverage's payment.
31 OTH_CVG_DRG_AMT NUMERIC No
This item holds the Diagnosis Related Group (DRG) amount identified on the other coverage's payment.
32 OTH_CVG_DSH_AMT NUMERIC No
This item holds the disproportionate share (DSH) amount identified on the other coverage's payment.
33 OTH_CVG_MSP_AMT NUMERIC No
This item holds the Medicare Secondary Payor (MSP) pass-through amount identified on the other coverage's payment.
34 OTH_CVG_PPS_AMT NUMERIC No
This item holds the Prospective Payment System (PPS) capital amount identified on the other coverage's payment.
35 OTH_CVG_FSP_DRG_AMT NUMERIC No
This item holds the Prospective Payment System (PPS) capital federal specific portion (FSP) Diagnosis Related Group (DRG) amount identified on the other coverage's payment.
36 OTH_CVG_HSP_DRG_AMT NUMERIC No
This item holds the Prospective Payment System (PPS) capital hospital specific portion (HSP) Diagnosis Related Group (DRG) amount identified on the other coverage's payment.
37 OTH_CVG_DSH_DRG_AMT NUMERIC No
This item holds the Prospective Payment System (PPS) capital disproportionate share (DSH) Diagnosis Related Group (DRG) amount identified on the other coverage's payment.
38 OTH_CVG_CAP_AMT NUMERIC No
This item holds the old capital amount identified on the other coverage's payment.
39 OTH_CVG_IME_AMT NUMERIC No
This item holds the Prospective Payment System (PPS) capital indirect medical education (IME) amount identified on the other coverage's payment.
40 OTH_CVG_OHS_DRG_AMT NUMERIC No
This item holds the Prospective Payment System (PPS) operating hospital specific portion (HSP) Diagnosis Related Group (DRG) amount identified on the other coverage's payment.
41 OTH_CVG_COST_DAY INTEGER No
This item holds the cost report days identified on the other coverage's payment.
42 OTH_CVG_OFS_DRG_AMT NUMERIC No
This item holds the Prospective Payment System (PPS) operating federal specific portion (FSP) Diagnosis Related Group (DRG) amount identified on the other coverage's payment.
43 OTH_CVG_OUTLIER_AMT NUMERIC No
This item holds the Prospective Payment System (PPS) capital outlier amount identified on the other coverage's payment.
44 OTH_CVG_TEACH_AMT NUMERIC No
This item holds the claim indirect teaching amount identified on the other coverage's payment.
45 OTH_CVG_IP_PROF_AMT NUMERIC No
This item holds the amount of the professional component billed on an inpatient claim but not payable as identified on the other coverage's payment.
46 OTH_CVG_EXCEPT_AMT NUMERIC No
This item holds the Prospective Payment System (PPS) capital exception amount identified on the other coverage's payment.
47 OTH_CVG_REIMB_RATE NUMERIC No
This item holds the reimbursement rate identified on the other coverage's payment.
48 OTH_CVG_HCPCS_AMT NUMERIC No
This item holds the Healthcare Common Procedure Coding System (HCPCS) payable amount identified on the other coverage's payment.
49 OTH_CVG_ESRD_AMT NUMERIC No
This item holds the end state renal disease (ESRD) payment amount identified on the other coverage's payment.
50 OTH_CVG_OP_PROF_AMT NUMERIC No
This item holds the amount of the professional component billed on an outpatient claim but not payable as identified on the other coverage's payment.
51 OTH_CVG_CAS_CEV_ID NUMERIC No
This item holds a pointer to an additional claim external value (CEV) record used to hold reason code (CAS) information for the claim. Only claim level values are stored in this reason code claim external value (CEV) record.
52 OTH_PYR_TPL_PYR_CD VARCHAR No
Payer code that identifies payer to Illinois Medicaid.
53 OTH_PYR_TPL_STAT_CD VARCHAR No
Status code that identifies how the other payer paid.
54 OTH_PYR_TPL_AMOUNT NUMERIC No
Payment amount made by (Third Party Liability) TPL payer.
55 OTH_PYR_TPL_DT DATETIME No
Third Party Liability (TPL) payment date.
56 OTH_CVG_TRUPAID_AMT NUMERIC No
This item is used to store the true paid amount from the other coverage payer. Does not include any adjustment amount.
57 OTH_CVG_ADJPAID_AMT NUMERIC No
This item is used to store the adjustment amount that should count as paid amount from an other coverage payor.
58 OTH_PYR_ASST_TYP VARCHAR No
The other payer's assistant dental surgeon entity type qualifier.