REFERRAL_5
Description:
The REFERRAL_5 table is a continuation of the REFERRAL_4 table. The REFERRAL_* tables are the primary tables for referral information stored in the system.

Primary Key
Column Name Ordinal Position
REFERRAL_ID 1

Column Information
Name Type Discontinued?
1 REFERRAL_ID NUMERIC No
The unique identifier for the referral record.
2 GEN_RFL_SEC_SINCE_MIDNIGHT_7 NUMERIC No
This contains information from generic referral time item 7.
3 GEN_RFL_SEC_SINCE_MIDNIGHT_8 NUMERIC No
This contains information from generic referral time item 8.
4 GEN_RFL_SEC_SINCE_MIDNIGHT_9 NUMERIC No
This contains information from generic referral time item 9.
5 GEN_RFL_SEC_SINCE_MIDNIGHT_10 NUMERIC No
This contains information from generic referral time item 10.
6 RPT_REF_TO_CNTRCT_YN VARCHAR No
Stores an override value that indicates the referred to provider/location/vendor/department should be considered contracted or not for Medicare Advantage ODAG reporting. If NULL, system defined logic will be used. If Y, a user marked the provider as contracted (CP in ODAG). If N, a user marked the provider as non-contracted (NCP in ODAG).
May contain organization-specific values: No
Category Entries:
No
Yes
7 RPT_REF_BY_CNTRCT_YN VARCHAR No
Stores an override value that indicates the referred by provider/location/department should be considered contracted or not for Medicare Advantage ODAG reporting. If NULL, system defined logic will be used. If Y, a user marked the provider as contracted (CP in ODAG). If N, a user marked the provider as non-contracted (NCP in ODAG).
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
8 LIVING_SITUATION_C_NAME VARCHAR No
Describes who the patient or child lives with.
May contain organization-specific values: Yes
No Entries Defined
9 FIRST_APPOINTMENT_BY_DATE DATETIME No
The date that the first appointment for the referral should occur by.
10 SENIORITY_DATE DATETIME No
The Seniority Date for the referral which represents a 'start date' that might have been set before the referral was created.
11 CASE_WORKER_NAME VARCHAR No
The case manager of the child psychology case.
12 CHILD_SERVICE_C_NAME VARCHAR No
Indicates the child welfare service role in connection with child psychology services.
May contain organization-specific values: Yes
No Entries Defined
13 PARENTAL_RESP_C_NAME VARCHAR No
Indicates which entity has parental responsibility for the patient.
May contain organization-specific values: Yes
No Entries Defined
14 CONSENT_TO_TREAT_STAT_C_NAME VARCHAR No
Indicates the status of obtaining the patient's consent in connection with the referral's transfer of medical record information.
May contain organization-specific values: Yes
No Entries Defined
15 FORWARDED_EVALUATION_DATE DATETIME No
This date represents the date an external organization evaluated or triaged the referral before forwarding it to an Epic instance. This date represents the internal concept of Triage History Instant, for the forwarding decision done at the external organization.
16 EMSG_COMM_PAT_ENC_CSN_ID NUMERIC No
This item is part of a link to a communication from which the referral was created. This item contains the CSN of the contact which contains the communication. EMSG_COMM_JOB_ID (I RFL 18961) contains the communication job ID.
17 EMSG_COMM_JOB_ID VARCHAR No
Part of a link to a communication from which the referral was created.
18 AUTHORIZED_MEDICATION_ID_MEDICATION_NAME VARCHAR No
The name of this medication record.
19 INITIAL_REQUEST_TYPE_C_NAME VARCHAR No
The initial request type for the referral.
May contain organization-specific values: No
Category Entries:
Preservice
Retro
Concurrent
20 REF_BY_CNTRCT_AT_AUTH_YN VARCHAR No
The contracted status of referred-by entities on the referral as of the last decision or the current contracted status if the referral is pending.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
21 REF_TO_CNTRCT_AT_AUTH_YN VARCHAR No
The contracted status of referred-to entities on the referral as of the last decision or the current contracted status if the referral is pending.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
22 REF_BY_SER_CNTRCT_AT_AUTH_YN VARCHAR No
The contracted status of referred-by provider on the referral as of the last decision or the current contracted status if the referral is pending.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
23 REF_TO_SER_CNTRCT_AT_AUTH_YN VARCHAR No
The contracted status of referred-to provider on the referral as of the last decision or the current contracted status if the referral is pending.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
24 REF_BY_EAF_CNTRCT_AT_AUTH_YN VARCHAR No
The contracted status of referred-by location on the referral as of the last decision or the current contracted status if the referral is pending.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
25 REF_TO_EAF_CNTRCT_AT_AUTH_YN VARCHAR No
The contracted status of referred-to location on the referral as of the last decision or the current contracted status if the referral is pending.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
26 REF_TO_VEN_CNTRCT_AT_AUTH_YN VARCHAR No
The contracted status of referred-to vendor on the referral as of the last decision or the current contracted status if the referral is pending.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
27 REF_BY_PROV_NET_LEVEL_C_NAME VARCHAR No
The network status of the referred-by provider on the referral.
May contain organization-specific values: Yes
Category Entries:
In Network
Out of Network
N/A
28 REF_TO_LOCATION_NET_LEVEL_C_NAME VARCHAR No
The network status of the referred-to location on the referral.
The category values for this column were already listed for column: REF_BY_PROV_NET_LEVEL_C_NAME
29 REF_TO_VENDOR_NET_LEVEL_C_NAME VARCHAR No
The network status of the referred-to vendor on the referral.
The category values for this column were already listed for column: REF_BY_PROV_NET_LEVEL_C_NAME
30 REF_TO_PROV_NET_LEVEL_C_NAME VARCHAR No
The network status of the referred-to provider on the referral.
The category values for this column were already listed for column: REF_BY_PROV_NET_LEVEL_C_NAME
31 REF_BY_LOCATION_NET_LEVEL_C_NAME VARCHAR No
The network status of the referred-by location on the referral.
The category values for this column were already listed for column: REF_BY_PROV_NET_LEVEL_C_NAME
32 RPT_REF_BY_SER_CNTRCT_YN VARCHAR No
The user override for the contracted status of the referred-by provider on the referral.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
33 RPT_REF_TO_SER_CNTRCT_YN VARCHAR No
The user override for the contracted status of the referred-to provider on the referral.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
34 RPT_REF_BY_EAF_CNTRCT_YN VARCHAR No
The user override for the contracted status of the referred-by location on the referral.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
35 RPT_REF_TO_EAF_CNTRCT_YN VARCHAR No
The user override for the contracted status of the referred-to location on the referral.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
36 RPT_REF_TO_VEN_CNTRCT_YN VARCHAR No
The user override for the contracted status of the referred-to vendor on the referral.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
37 RFL_AUTH_PROG_C_NAME VARCHAR No
Authorization Prognosis code associated with a referral
May contain organization-specific values: Yes
38 PRINCIPAL_DX_DATE DATETIME No
Specifies the diagnois date used for Prinicpal Diagnosis
39 ADMISSION_SOURCE_C_NAME VARCHAR No
The source from which the paitent is being admitted or referred. Only available in UM referrals.
May contain organization-specific values: Yes
40 DISCHRG_DISP_C_NAME VARCHAR No
This disposition (location) of the patient after discharge. Only available in UM referrals.
May contain organization-specific values: Yes
41 FIRST_PAT_ENC_CSN_ID NUMERIC No
Ths CSN of the encounter linked to the referral or auth/cert with the earliest encounter instant.
42 LAST_PAT_ENC_CSN_ID NUMERIC No
Ths CSN of the encounter linked to the referral or auth/cert with the latest encounter instant.
43 REF_BY_CNTRCT_AT_DEC_YN VARCHAR No
The contracted status of referred-by entities on the referral as of the last decision.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
44 REF_TO_CNTRCT_AT_DEC_YN VARCHAR No
The contracted status of referred-to entities on the referral as of the last decision.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
45 REF_BY_SER_CNTRCT_AT_DEC_YN VARCHAR No
The contracted status of referred-by provider on the referral as of the last decision.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
46 REF_TO_SER_CNTRCT_AT_DEC_YN VARCHAR No
The contracted status of referred-to provider on the referral as of the last decision.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
47 REF_BY_LOC_CNTRCT_AT_DEC_YN VARCHAR No
The contracted status of referred-by location on the referral as of the last decision.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
48 REF_TO_LOC_CNTRCT_AT_DEC_YN VARCHAR No
The contracted status of referred-to location on the referral as of the last decision.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
49 REF_TO_VEN_CNTRCT_AT_DEC_YN VARCHAR No
The contracted status of referred-to vendor on the referral as of the last decision.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
50 REGION_ID_LOC_NAME VARCHAR No
The name of the revenue location.
51 MEDICAL_GROUP_ID_LOC_NAME VARCHAR No
The name of the revenue location.
52 PRIMARY_CONDITION_GROUPER_ID_GROUPER_NAME VARCHAR No
Record name
53 PRIMARY_TREATMENT_GROUPER_ID_GROUPER_NAME VARCHAR No
Record name
54 PRIMARY_SPECIALTY_GROUPER_ID_GROUPER_NAME VARCHAR No
Record name
55 PRIMARY_SUBSPEC_GROUPER_ID_GROUPER_NAME VARCHAR No
Record name
56 CONC_UM_REV_TRANS_FROM_DELE_YN VARCHAR No
Indicates if the responsiblity for concurrent review of this authorization request has been transitioned from a delegate system to this UM system.
The category values for this column were already listed for column: RPT_REF_TO_CNTRCT_YN
57 MED_ESTIMATE_CSN_ID NUMERIC No
This item holds the contact serial number (CSN) of the medication estimate (LME) that was linked to the associated order when this referral was created. This item is not populated for renewals.
58 CLM_NET_OVRIDE_STAT_C_NAME VARCHAR No
The network status to override to when adjudicating the linked claim.
May contain organization-specific values: No
Category Entries:
None
In Network
Out of Network
59 CLM_NET_OVRIDE_LVL_C_NAME VARCHAR No
The network level to override to when adjudicating the linked claim.
May contain organization-specific values: Yes
Category Entries:
Not Leveled
60 CLM_NET_OVRIDE_RSN_C_NAME VARCHAR No
The reason for override a linked claim's adjudication network.
May contain organization-specific values: Yes