PR_EST_AP_CLAIM_PROC

Description:

This table stores service line information for managed care estimates.

Primary Key

Column Name	Ordinal Position
ESTIMATE_ID	1
LINE	2

Column Information

	Name	Type	Discontinued?
1	ESTIMATE_ID	NUMERIC	No
	The unique identifier for the patient estimate 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	CONTEXT_LINE	INTEGER	No
	The LINE in the PR_EST_AP_CLAIM table that stores the claim information that this service line is associated with.
4	PROC_MODS	VARCHAR	No
	The modifiers associated with the service line.
5	PROC_QTY	INTEGER	No
	The procedure quantity associated with the service line.
6	CHG_AMT	NUMERIC	No
	The billed amount associated with the service line.
7	SYS_CHG_AMT	NUMERIC	No
	The system-calculated billed amount associated with the service line detail.
8	ALLOW_AMT	NUMERIC	No
	The allowed amount associated with the service line.
9	SYS_ALLOW_AMT	NUMERIC	No
	The system-calculated allowed amount associated with the service line detail.
10	SELF_PAY_AMT	NUMERIC	No
	The self-pay amount associated with the service line.
11	SYS_SELF_PAY_AMT	NUMERIC	No
	The system-calculated self-pay amount associated with the service line detail.
12	MC_ADDL_LINE	INTEGER	No
	The LINE in the PR_EST_ADDL_INFO table that stores additional information about the service line.
13	TX_ID	NUMERIC	No
	The AP Claims transaction (ETR) ID associated with this estimate procedure line.
14	AUTH_REQUIRED_YN	VARCHAR	No
	Identifies if an authorization is required for the procedure line to be covered. May contain organization-specific values: No Category Entries: No Yes
15	DRG_ID	VARCHAR	No
	The Diagnosis Related Group (DRG) associated with the service line detail.
16	DRG_ID_DRG_NAME	VARCHAR	No
	The name of the Diagnoses Related Group name.
17	MC_NETWORK_LEVELS_C_NAME	VARCHAR	No
	Indicates if the service is priced to be In or Out of network. May contain organization-specific values: Yes Category Entries: In Out Out of Area N/A
18	MC_CLICKED_ON_YN	VARCHAR	No
	Signals if the line was clicked on by the member The category values for this column were already listed for column: AUTH_REQUIRED_YN
19	MC_IS_ANCHOR_YN	VARCHAR	No
	This indicates whether the associated procedure is what the member searched for in Cost Calc (Aka. Anchor) The category values for this column were already listed for column: AUTH_REQUIRED_YN