claim_coverage

Provides information about member coverage for a specific plan during service dates

Primary Key:

• claim_id
• member_coverage_id
• claim_coverage_date_from
• claim_coverage_date_through

Foreign Keys:

• claim_id => claim.claim_id
• member_coverage_id => member_coverage.member_coverage_id
• plan_chosen_by => login.login_id
• plan_id_chosen => plan.plan_id

Indexes:

• claim_coverage_claim_id_idx - claim_id
• claim_coverage_member_coverage_id_idx - member_coverage_id
• claim_coverage_plan_chosen_by_idx - plan_chosen_by
• claim_coverage_plan_id_chosen_idx - plan_id_chosen

Column	Data Type	Nullable	Indexed	Description
claim_id	bigint	No	Yes	Link to the claim record.
claim_coverage_date_from	date	No	Yes	Date that coverage begins for this claim. In most cases, this will be the same date as begin date of the claim. For long hospital stays it is possible for insurance coverage to lapse during the stay. In this case, the coverage from date may not be the same as the admit date..
claim_coverage_date_through	date	No	Yes	Date that coverage ends for this claim. In most cases, this will be the same date as end date of the claim. For long hospital stays it is possible for insurance coverage to lapse during the stay. In this case, the coverage end date may not be the same as the discharge date.
member_coverage_id	bigint	No	Yes	Link to the member coverage that the claim was matched to.
plan_id_chosen	bigint	Yes	Yes	The plan which provides coverage for the claim during the specified dates.
plan_chosen_by	bigint	Yes	Yes	The ID of the person or automation user which was responsible for selecting the plan.
plan_chosen_at	date	Yes	No	The time the plan was chosen.