Claim Item DMO

Object Properties

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

Relationships

• InsurancePolicyAssetId has a FOREIGNKEY relationship with the Insurance Policy Asset DMO Id field.
• InsurancePolicyCoverageId has a FOREIGNKEY relationship with the Insurance Policy Coverage DMO Id field.
• ItemCodeId has a FOREIGNKEY relationship with the Code Set Bundle DMO Id field.
• ItemCodeId has a FOREIGNKEY relationship with the Code Set DMO Id field.
• ClaimId has a FOREIGNKEY relationship with the Claim DMO Id field.
• ClaimParticipantId has a FOREIGNKEY relationship with the Claim Participant DMO Id field.
• CoverageCategoryCodeId has a FOREIGNKEY relationship with the Code Set Bundle DMO Id field.
• CoverageCategoryCodeId has a FOREIGNKEY relationship with the Code Set DMO Id field.
• LocationId has a FOREIGNKEY relationship with the Location DMO Id field.
• QuantityUnitOfMeasureId has a FOREIGNKEY relationship with the Unit of Measure DMO Id field.
• ServicingFacilityId has a FOREIGNKEY relationship with the Healthcare Facility DMO Id field.
• AssetId has a FOREIGNKEY relationship with the Asset DMO Id field.

Fields

• AddedByType
• AssetId
• cdp_sys_record_currency
• ClaimId
• ClaimParticipantId
• CoInsAmount
• CoInsuranceAmt
• CoPayAmount
• CoverageCategoryCodeId
• CoverageCategoryCodeObject
• DataSourceId
• DataSourceObjectId
• DeductibleAmount
• DeductibleUnallocatedAmount
• DispositionText
• EligibleAmount
• EligiblePercent
• Id
• InsurancePolicyAssetId
• InsurancePolicyCoverageId
• InternalOrganizationId
• ItemCategory
• ItemCodeId
• ItemCodeObject
• KQ_AssetId
• KQ_ClaimId
• KQ_ClaimParticipantId
• KQ_CoverageCategoryCodeId
• KQ_Id
• KQ_InsurancePolicyAssetId
• KQ_InsurancePolicyCoverageId
• KQ_ItemCodeId
• KQ_LocationId
• KQ_QuantityUnitOfMeasureId
• KQ_ServicingFacilityId
• LocationId
• Name
• OutcomeText
• PayableAmount
• PreauthIdentifier
• PriceAdjustmentValueNumber
• Quantity
• QuantityUnitOfMeasureId
• ServicedEndDateTime
• ServicedStartDateTime
• ServicingFacilityId
• TaxAmount
• TotalAmount
• UnitPriceAmount

AddedByType

• Field API Name: ssot__AddedByType__c
• Data Type: TEXT
• Description: The origin/source who added the item. For example, Provider, Payer.

AssetId

• Field API Name: ssot__AssetId__c
• Data Type: TEXT
• Description: The asset associated with the claim.

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.

ClaimId

• Field API Name: ssot__ClaimId__c
• Data Type: TEXT
• Description: The parent claim that includes this claim item.

ClaimParticipantId

• Field API Name: ssot__ClaimParticipantId__c
• Data Type: TEXT
• Description: The claim participant associated with the claim item.

CoInsAmount

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

CoInsuranceAmt

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

CoPayAmount

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

CoverageCategoryCodeId

• Field API Name: ssot__CoverageCategoryCodeId__c
• Data Type: TEXT
• Description: The code to identify the general category of insurance coverage under which products and services are provided.

CoverageCategoryCodeObject

• Field API Name: ssot__CoverageCategoryCodeObject__c
• Data Type: TEXT
• Description: The object name for the Coverage Category Code field record.

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.

DispositionText

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

Id

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

InsurancePolicyAssetId

• Field API Name: ssot__InsurancePolicyAssetId__c
• Data Type: TEXT
• Description: The insurance policy asset associated with the claim item.

InsurancePolicyCoverageId

• Field API Name: ssot__InsurancePolicyCoverageId__c
• Data Type: TEXT
• Description: The ID of the coverage that covers this claim item.

InternalOrganizationId

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

ItemCategory

• Field API Name: ssot__ItemCategory__c
• Data Type: TEXT
• Description: The category of the claim item. For example, Damaged Property, Involved Injury.

ItemCodeId

• Field API Name: ssot__ItemCodeId__c
• Data Type: TEXT
• Description: The product/service/other item which is being claimed.

ItemCodeObject

• Field API Name: ssot__ItemCodeObject__c
• Data Type: TEXT
• Description: The object name for the Item Code field record.

KQ_AssetId

• Field API Name: KQ_AssetId__c
• Data Type: TEXT
• Description: Key Qualifier system field for AssetId

KQ_ClaimId

• Field API Name: KQ_ClaimId__c
• Data Type: TEXT
• Description: Key Qualifier system field for ClaimId

KQ_ClaimParticipantId

• Field API Name: KQ_ClaimParticipantId__c
• Data Type: TEXT
• Description: Key Qualifier system field for ClaimParticipantId

KQ_CoverageCategoryCodeId

• Field API Name: KQ_CoverageCategoryCodeId__c
• Data Type: TEXT
• Description: Key Qualifier system field for CoverageCategoryCodeId

KQ_Id

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

KQ_InsurancePolicyAssetId

• Field API Name: KQ_InsurancePolicyAssetId__c
• Data Type: TEXT
• Description: Key Qualifier system field for InsurancePolicyAssetId

KQ_InsurancePolicyCoverageId

• Field API Name: KQ_InsurancePolicyCoverageId__c
• Data Type: TEXT
• Description: Key Qualifier system field for InsurancePolicyCoverageId

KQ_ItemCodeId

• Field API Name: KQ_ItemCodeId__c
• Data Type: TEXT
• Description: Key Qualifier system field for ItemCodeId

KQ_LocationId

• Field API Name: KQ_LocationId__c
• Data Type: TEXT
• Description: Key Qualifier system field for LocationId

KQ_QuantityUnitOfMeasureId

• Field API Name: KQ_QuantityUnitOfMeasureId__c
• Data Type: TEXT
• Description: Key Qualifier system field for QuantityUnitOfMeasureId

KQ_ServicingFacilityId

• Field API Name: KQ_ServicingFacilityId__c
• Data Type: TEXT
• Description: Key Qualifier system field for ServicingFacilityId

LocationId

• Field API Name: ssot__LocationId__c
• Data Type: TEXT
• Description: The location at which item serviced or provided.

Name

• Field API Name: ssot__Name__c
• Data Type: TEXT
• Description: Name of the item that's included in the claim.

OutcomeText

• Field API Name: ssot__OutcomeText__c
• Data Type: TEXT
• Description: Indicates whether the claim item was processed.

PayableAmount

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

PreauthIdentifier

• Field API Name: ssot__PreauthIdentifier__c
• Data Type: TEXT
• Description: The prior authorization reference number associated with this claim item.

PriceAdjustmentValueNumber

• Field API Name: ssot__PriceAdjustmentValueNumber__c
• Data Type: DOUBLE
• Description: The multiplier used to allow for a discount or surcharge an item price.

Quantity

• Field API Name: ssot__Quantity__c
• Data Type: DOUBLE
• Description: The quantity supplied/performed of the item.

QuantityUnitOfMeasureId

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

ServicedEndDateTime

• Field API Name: ssot__ServicedEndDateTime__c
• Data Type: DATETIME
• Description: The end date on which the claim item is supplied/peformed.

ServicedStartDateTime

• Field API Name: ssot__ServicedStartDateTime__c
• Data Type: DATETIME
• Description: The start date on which the claim item is supplied/peformed.

ServicingFacilityId

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

TaxAmount

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

TotalAmount

• Field API Name: ssot__TotalAmount__c
• Data Type: DOUBLE
• Description: The total amount of an item, by multiplying quantity to unit price and price adjustment if any.

UnitPriceAmount

• Field API Name: ssot__UnitPriceAmount__c
• Data Type: DOUBLE
• Description: The fee/price/charges of the item per unit.