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Claim DMO

Object Properties

Object API Name: ssot__Claim__dlm
Category: Unassigned
Availability: Available in 254 and later versions
Primary Key Field: Id

Relationships

  • SubTypeId has a FOREIGNKEY relationship with the Code Set DMO Id field.
  • TypeId has a FOREIGNKEY relationship with the Code Set DMO Id field.
  • ResponsiblePartyId has a FOREIGNKEY relationship with the Healthcare Provider DMO Id field.
  • ServicingLocationId has a FOREIGNKEY relationship with the Healthcare Facility DMO Id field.
  • ServicingLocationId has a FOREIGNKEY relationship with the Location DMO Id field.
  • StatusId has a FOREIGNKEY relationship with the Code Set DMO Id field.
  • ClaimantId has a FOREIGNKEY relationship with the Patient DMO Id field.
  • OwnerId has a FOREIGNKEY relationship with the User DMO Id field.
  • PrimaryInsuredAssetId has a FOREIGNKEY relationship with the Insurance Policy Asset DMO Id field.
  • PriorityId has a FOREIGNKEY relationship with the Code Set DMO Id field.
  • ResponsiblePartyId has a FOREIGNKEY relationship with the Account DMO Id field.
  • IncidentId has a FOREIGNKEY relationship with the Incident DMO Id field.
  • InsurancePolicyId has a FOREIGNKEY relationship with the Insurance Policy DMO Id field.
  • InsurancePolicyId has a FOREIGNKEY relationship with the Member Plan DMO Id field.
  • InsurerId has a FOREIGNKEY relationship with the Account DMO Id field.
  • AuthoredById has a FOREIGNKEY relationship with the Healthcare Provider DMO Id field.
  • ClaimPaymentId has a FOREIGNKEY relationship with the Claim Payment DMO Id field.
  • ClaimantId has a FOREIGNKEY relationship with the Account DMO Id field.
  • ClaimantId has a FOREIGNKEY relationship with the Individual DMO Id field.
  • PayeeRecordId has a FOREIGNKEY relationship with the Individual DMO Id field.
  • PayeeRecordId has a FOREIGNKEY relationship with the Healthcare Provider DMO Id field.
  • PayeeRecordId has a FOREIGNKEY relationship with the Account Contact DMO Id field.
  • PayeeRecordId has a FOREIGNKEY relationship with the Account DMO Id field.
  • PayeeRecordId has a FOREIGNKEY relationship with the Party DMO Id field.

Fields

ApprovedAmount

  • Field API Name: ssot__ApprovedAmount__c
  • Data Type: DOUBLE
  • Description: The amount that was approved for the repair of damages based on an agent's inspection.

AssessmentDateTime

  • Field API Name: ssot__AssessmentDateTime__c
  • Data Type: DATETIME
  • Description: The date on which the claim was officially assessed.

AuthoredById

  • Field API Name: ssot__AuthoredById__c
  • Data Type: TEXT
  • Description: Represents an Individual who authored/created the claim, predetermination or preauthorization.

AuthoredByObject

  • Field API Name: ssot__AuthoredByObject__c
  • Data Type: TEXT
  • Description: The object name for the Entered By field record.

BilledAmount

  • Field API Name: ssot__BilledAmount__c
  • Data Type: DOUBLE
  • Description: The actual billed amount that was being claimed.

BillingEndDate

  • Field API Name: ssot__BillingEndDate__c
  • Data Type: DATETIME
  • Description: The end date of the billing billing period for which the claim charges being submitted.

BillingEndDt

  • Field API Name: ssot__BillingEndDt__c
  • Data Type: DATEONLY
  • Description: Calendar date representing the billing end dt in the YYYY-MM-DD format.

BillingStartDate

  • Field API Name: ssot__BillingStartDate__c
  • Data Type: DATETIME
  • Description: The start date of the billing billing period for which the claim charges being submitted.

BillingStartDt

  • Field API Name: ssot__BillingStartDt__c
  • Data Type: DATEONLY
  • Description: Calendar date representing the billing start dt in the YYYY-MM-DD format.

Category

  • Field API Name: ssot__Category__c
  • Data Type: TEXT
  • Description: The category of the claim record. For example, Claim, Preauthorization, Predetermination.

cdp_sys_record_currency

  • Field API Name: ssot__cdp_sys_record_currency__c
  • Data Type: TEXT
  • Description: System-generated metadata field that stores a 3-letter ISO currency code.

ChannelType

  • Field API Name: ssot__ChannelType__c
  • Data Type: TEXT
  • Description: Represnts the communication channel type for claim.

ClaimantId

  • Field API Name: ssot__ClaimantId__c
  • Data Type: TEXT
  • Description: The Account/Party to whom the professional services and/or products have been supplied or are being considered and for whom actual for forecast reimbursement is sought.

ClaimantObject

  • Field API Name: ssot__ClaimantObject__c
  • Data Type: TEXT
  • Description: The object name for the claimant field record.

ClaimPaymentId

  • Field API Name: ssot__ClaimPaymentId__c
  • Data Type: TEXT
  • Description: The reference to final claim payment done for the claim.

CoPayAmount

  • Field API Name: ssot__CoPayAmount__c
  • Data Type: DOUBLE
  • Description: The co-pay amount for patient.

CreatedDate

  • Field API Name: ssot__CreatedDate__c
  • Data Type: DATETIME
  • Description: The date and time the record was originally created.

DataSourceId

  • Field API Name: ssot__DataSourceId__c
  • Data Type: TEXT
  • Description: A unique, system-generated identifier for this record.

DataSourceObjectId

  • Field API Name: ssot__DataSourceObjectId__c
  • Data Type: TEXT
  • Description: A unique, system-generated identifier for this record.

DeductibleAmount

  • Field API Name: ssot__DeductibleAmount__c
  • Data Type: DOUBLE
  • Description: Amount deducted from the eligible amount prior to adjudication.

DeductibleUnallocatedAmount

  • Field API Name: ssot__DeductibleUnallocatedAmount__c
  • Data Type: DOUBLE
  • Description: The amount of deductible that's not allocated to other line items.

Description

  • Field API Name: ssot__Description__c
  • Data Type: TEXT
  • Description: Description of the Claim.

DispositionText

  • Field API Name: ssot__DispositionText__c
  • Data Type: TEXT
  • Description: The adjudication result or claim disposition status.

EligibleAmount

  • Field API Name: ssot__EligibleAmount__c
  • Data Type: DOUBLE
  • Description: Amount of the change which is considered for adjudication.

EligiblePercent

  • Field API Name: ssot__EligiblePercent__c
  • Data Type: DOUBLE
  • Description: The percentage value for eligible percent of the claim.

FinalizedDateTime

  • Field API Name: ssot__FinalizedDateTime__c
  • Data Type: DATETIME
  • Description: Represnts the data on which claim was marked as resolved, with claim status as approved or rejected.

Id

  • Field API Name: ssot__Id__c
  • Data Type: TEXT
  • Description: Required. A unique, system-generated identifier for this Claim record. Maximum size is 15 characters.

IncidentId

  • Field API Name: ssot__IncidentId__c
  • Data Type: TEXT
  • Description: The incident/accident/occurence event which resulted into filing this claim.

InitiationDateTime

  • Field API Name: ssot__InitiationDateTime__c
  • Data Type: DATETIME
  • Description: Represent the date on which the claim is initiated.

InitiationDt

  • Field API Name: ssot__InitiationDt__c
  • Data Type: DATEONLY
  • Description: Calendar date representing the initiation dt in the YYYY-MM-DD format.

InsurancePolicyId

  • Field API Name: ssot__InsurancePolicyId__c
  • Data Type: TEXT
  • Description: The insurance policy record id.

InsurancePolicyObject

  • Field API Name: ssot__InsurancePolicyObject__c
  • Data Type: TEXT
  • Description: The object name for the Insurance Policy field record.

InsurerId

  • Field API Name: ssot__InsurerId__c
  • Data Type: TEXT
  • Description: The Account/Party responsible for reimbursement of the claim.

InternalOrganizationId

  • Field API Name: ssot__InternalOrganizationId__c
  • Data Type: TEXT
  • Description: A unique, system-generated identifier for this record.

IsClosed

  • Field API Name: ssot__IsClosed__c
  • Data Type: BOOLEAN
  • Description: Indicates whether the claim is closed.

IsDriveable

  • Field API Name: ssot__IsDriveable__c
  • Data Type: BOOLEAN
  • Description: Whether the asset/vehicle is drivable after the accident. The default value is False.

IsInhabitable

  • Field API Name: ssot__IsInhabitable__c
  • Data Type: BOOLEAN
  • Description: Whether the asset/property is inhabitable after the accident. The default value is False.

KQ_AuthoredById

  • Field API Name: KQ_AuthoredById__c
  • Data Type: TEXT
  • Description: Key Qualifier system field for AuthoredById

KQ_ClaimantId

  • Field API Name: KQ_ClaimantId__c
  • Data Type: TEXT
  • Description: Key Qualifier system field for ClaimantId

KQ_ClaimPaymentId

  • Field API Name: KQ_ClaimPaymentId__c
  • Data Type: TEXT
  • Description: Key Qualifier system field for ClaimPaymentId

KQ_Id

  • Field API Name: KQ_Id__c
  • Data Type: TEXT
  • Description: Key Qualifier system field for Id

KQ_IncidentId

  • Field API Name: KQ_IncidentId__c
  • Data Type: TEXT
  • Description: Key Qualifier system field for IncidentId

KQ_InsurancePolicyId

  • Field API Name: KQ_InsurancePolicyId__c
  • Data Type: TEXT
  • Description: Key Qualifier system field for InsurancePolicyId

KQ_InsurerId

  • Field API Name: KQ_InsurerId__c
  • Data Type: TEXT
  • Description: Key Qualifier system field for InsurerId

KQ_OwnerId

  • Field API Name: KQ_OwnerId__c
  • Data Type: TEXT
  • Description: Key Qualifier system field for OwnerId

KQ_PayeeRecordId

  • Field API Name: KQ_PayeeRecordId__c
  • Data Type: TEXT
  • Description: Key Qualifier system field for PayeeRecordId

KQ_PrimaryInsuredAssetId

  • Field API Name: KQ_PrimaryInsuredAssetId__c
  • Data Type: TEXT
  • Description: Key Qualifier system field for PrimaryInsuredAssetId

KQ_PriorityId

  • Field API Name: KQ_PriorityId__c
  • Data Type: TEXT
  • Description: Key Qualifier system field for PriorityId

KQ_ResponsiblePartyId

  • Field API Name: KQ_ResponsiblePartyId__c
  • Data Type: TEXT
  • Description: Key Qualifier system field for ResponsiblePartyId

KQ_ServicingLocationId

  • Field API Name: KQ_ServicingLocationId__c
  • Data Type: TEXT
  • Description: Key Qualifier system field for ServicingLocationId

KQ_StatusId

  • Field API Name: KQ_StatusId__c
  • Data Type: TEXT
  • Description: Key Qualifier system field for StatusId

KQ_SubTypeId

  • Field API Name: KQ_SubTypeId__c
  • Data Type: TEXT
  • Description: Key Qualifier system field for SubTypeId

KQ_TypeId

  • Field API Name: KQ_TypeId__c
  • Data Type: TEXT
  • Description: Key Qualifier system field for TypeId

LastModifiedDateTime

  • Field API Name: ssot__LastModifiedDateTime__c
  • Data Type: DATETIME
  • Description: The date and time when the claim was last modified.

LossDateTime

  • Field API Name: ssot__LossDateTime__c
  • Data Type: DATETIME
  • Description: The date on which the accident took place.

LossType

  • Field API Name: ssot__LossType__c
  • Data Type: TEXT
  • Description: The type of the loss for which the claim was initiated. For example, partial loss, repair, replacement.

Name

  • Field API Name: ssot__Name__c
  • Data Type: TEXT
  • Description: Name of the Claim.

OutcomeType

  • Field API Name: ssot__OutcomeType__c
  • Data Type: TEXT
  • Description: Alphanumeric string representing the outcome type.

OwnerId

  • Field API Name: ssot__OwnerId__c
  • Data Type: TEXT
  • Description: Represents ID of the record owner.

PayableAmount

  • Field API Name: ssot__PayableAmount__c
  • Data Type: DOUBLE
  • Description: Amount payable under the coverage.

PayeeObject

  • Field API Name: ssot__PayeeObject__c
  • Data Type: TEXT
  • Description: The object type of the payee, such as Account, Contact, Provider, etc.

PayeeRecordId

  • Field API Name: ssot__PayeeRecordId__c
  • Data Type: TEXT
  • Description: The reference ID of the payee record.

PayeeType

  • Field API Name: ssot__PayeeType__c
  • Data Type: TEXT
  • Description: The type of payee, such as Subscriber or Provider.

PreauthIdentifier

  • Field API Name: ssot__PreauthIdentifier__c
  • Data Type: TEXT
  • Description: The reference number of the prior authorization.

PrimaryInsuredAssetId

  • Field API Name: ssot__PrimaryInsuredAssetId__c
  • Data Type: TEXT
  • Description: The primary insured asset for the claim.

PriorityId

  • Field API Name: ssot__PriorityId__c
  • Data Type: TEXT
  • Description: The priority of processing the claim request. For example, Immediate, Normal, Deferred.

ReasonText

  • Field API Name: ssot__ReasonText__c
  • Data Type: TEXT
  • Description: The reason for initiating the claim.

ReasonType

  • Field API Name: ssot__ReasonType__c
  • Data Type: TEXT
  • Description: The type of the claim reason belong to. For example, Natural Disaster, Accident.

ResponsiblePartyId

  • Field API Name: ssot__ResponsiblePartyId__c
  • Data Type: TEXT
  • Description: The party which is responsible for the claim, predetermination or preauthorization.

ResponsiblePartyObject

  • Field API Name: ssot__ResponsiblePartyObject__c
  • Data Type: TEXT
  • Description: The object name for the Responsible Party field record.

ServicingLocationId

  • Field API Name: ssot__ServicingLocationId__c
  • Data Type: TEXT
  • Description: The servicing facility/location where the services were provided.

ServicingLocationObject

  • Field API Name: ssot__ServicingLocationObject__c
  • Data Type: TEXT
  • Description: The object name for the Servicing Location field record.

SiteVisitDateTime

  • Field API Name: ssot__SiteVisitDateTime__c
  • Data Type: DATETIME
  • Description: The timestamp for when the agent visited the site of the accident or the place where the vehicle was moved after the accident.

StatusId

  • Field API Name: ssot__StatusId__c
  • Data Type: TEXT
  • Description: The status of the claim record. For example, Draft, Cancelled, Active, Entered in Error.

SubmittedAmount

  • Field API Name: ssot__SubmittedAmount__c
  • Data Type: DOUBLE
  • Description: The total submitted amount for the claim or group or line item.

SubTypeId

  • Field API Name: ssot__SubTypeId__c
  • Data Type: TEXT
  • Description: The finer grained suite of claim type which may convey additional information. For example, Inpatient, Outpatient, Specialty Service.

SummaryText

  • Field API Name: ssot__SummaryText__c
  • Data Type: TEXT
  • Description: The human readable summary of the status of the claim.

TaxAmount

  • Field API Name: ssot__TaxAmount__c
  • Data Type: DOUBLE
  • Description: The tax amount for the claim.

TentativeServiceDate

  • Field API Name: ssot__TentativeServiceDate__c
  • Data Type: DATEONLY
  • Description: Calendar date representing the tentative service date in the YYYY-MM-DD format.

TotalCoInsAmount

  • Field API Name: ssot__TotalCoInsAmount__c
  • Data Type: DOUBLE
  • Description: Numeric value representing the total co ins amount. Do not include currency symbols or commas.

TotalCoInsuranceAmt

  • Field API Name: ssot__TotalCoInsuranceAmt__c
  • Data Type: CURRENCY
  • Description: Monetary amount representing the total co insurance amt. Do not include currency symbols or commas.

TotalCoPayAmount

  • Field API Name: ssot__TotalCoPayAmount__c
  • Data Type: DOUBLE
  • Description: The total co-pay amount for patient.

TotalDeductibleAmount

  • Field API Name: ssot__TotalDeductibleAmount__c
  • Data Type: DOUBLE
  • Description: The total amount deducted from the eligible amount prior to adjudication.

TotalDeductibleUnallocatedAmount

  • Field API Name: ssot__TotalDeductibleUnallocatedAmount__c
  • Data Type: DOUBLE
  • Description: The total amount of deductible that's not allocated to other line items.

TotalEligibleAmount

  • Field API Name: ssot__TotalEligibleAmount__c
  • Data Type: DOUBLE
  • Description: The total amount of the change which is considered for adjudication.

TotalEligiblePercent

  • Field API Name: ssot__TotalEligiblePercent__c
  • Data Type: DOUBLE
  • Description: The total eligible percentage.

TotalPayableAmount

  • Field API Name: ssot__TotalPayableAmount__c
  • Data Type: DOUBLE
  • Description: The total amount payable under the claim.

TotalTaxAmount

  • Field API Name: ssot__TotalTaxAmount__c
  • Data Type: DOUBLE
  • Description: The total tax amount.

TypeId

  • Field API Name: ssot__TypeId__c
  • Data Type: TEXT
  • Description: The type of the claim record. For example, Oral, Pharmacy, Vision, Institutional.

UniqueIdentifier

  • Field API Name: ssot__UniqueIdentifier__c
  • Data Type: TEXT
  • Description: The unique identifier of the claim.