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Name | Type | Mandatory | Default | Explanation |
---|---|---|---|---|
ClaimItemID | int (PK) | YES | ||
ClaimID | int | YES | FK tblClaim | |
ItemID | int | YES | FK tblItems | |
ProdID | int | NO | FK tblProduct | |
ClaimItemStatus | tinyint | YES | 1 | 1: Accepted | 2: Rejected |
Availability | bit | YES | 1 | If the medical item is available or not in the HF. |
QtyProvided | decimal(18, 2) | YES | Quantity provided by HF. | |
QtyApproved | decimal(18, 2) | NO | Quantity approved by Medical Officer when reviewing manually. If NULL then same as QtyProvided. | |
PriceAsked | decimal(18, 2) | YES | Price per unit asked by HF. | |
PriceAdjusted | decimal(18, 2) | NO | Price calculated automatically based on Product configuration when Processing the Claim. | |
PriceApproved | decimal(18, 2) | NO | Price approved by Medical Officer when reviewing manually. If NULL then same as PriceAsked. | |
PriceValuated | decimal(18, 2) | NO | Total price calculated automatically for the item: PriceAdjusted * QtyApproved | |
Explanation | ntext | NO | Explanation from HF (text). | |
Justification | ntext | NO | Justification from Medical Officer when reviewing manually (text). | |
RejectionReason | smallint | NO | 0 | One of the values (value: meaning): |
ValidityFromReview | datetime | NO | ||
ValidityToReview | datetime | NO | ||
AuditUserIDReview | int | NO | ||
LimitationValue | decimal(18, 2) | NO | ||
Limitation | char(1) | NO | ||
PolicyID | int | NO | ||
RemuneratedAmount | decimal(18, 2) | NO | ||
DeductableAmount | decimal(18, 2) | NO | ||
ExceedCeilingAmount | decimal(18, 2) | NO | ||
PriceOrigin | char(1) | NO | ||
ExceedCeilingAmountCategory | decimal(18, 2) | NO | ||
ValidityFrom | datetime | YES | Current date | |
ValidityTo | datetime | NO | ||
LegacyID | int | NO | ||
AuditUserID | int | YES |
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