Table Description

Medical Insurance: A type of insurance that covers the costs of medical treatment and provides medical care and facilities during recovery.

A Household Member may have his or her own medical insurance policy or be covered under someone else's policy. For example, children in a household may be covered by a non-custodial parent's medical insurance policy.
Medical Insurance evidence captures the policyholder details, insurance company name and address, and information on the policy itself such as the policy start date, the premium paid and the medical insurance type, for example, major medical or basic hospital. The policyholder is a Household Member or someone living outside the home.
The policyholder may be an employee who has a policy under an employer group. If this situation, the group policy details such as the employer name and group policy number are also recorded.

Example

Linda Smith has purchased medical insurance coverage from an insurance company. Linda Smith is the policyholder under her employer's group. A case worker creates a Medical Insurance record in which her group policy details, insurance company and policy details are listed.

Relationship Diagram
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Model Details
Location in Model: Logical View::MetaModel::Curam::Evidence::Service Layer::Entity::Resources::MedicalInsurance::MedicalInsurance
Controlling File: Evidence\model\ServiceLayer\entity\Resources\MedicalInsurance\MedicalInsurance_cat.efx
Table Options
ALLOW_OPTIMISTIC_LOCKINGyes
Attributes (16)
AttributeStereotypeNullableDescriptionDomain DefinitionCodetableDDL Type
evidenceIDkeyno

System generated unique identifier for the Medical Insurance.

EVIDENCE_ID SVR_INT64
plchdrCaseParticipantRoleIDdetailsno

The Case Participant Role ID of the individual who owns the Medical Insurance. This may or may not be a Household Member. For example, the policyholder could be a non-custodial parent.

CASE_PARTICIPANT_ROLE_ID SVR_INT64
policyNumberdetails 

The Medical Insurance policy/certificate number. If the Medical Insurance is a group insurance, the insurance policy/certificate number is the policy holder's specific certificate number.

EVD_POLICY_NUMBER SVR_STRING<30>
groupPolicyNumberdetails 

The number of the group policy under which the employee is covered.

EVD_GROUP_POLICY_NUMBER SVR_STRING<30>
groupCaseParticipantRoleIDdetailsyes

The Case Participant Role ID of the employer providing the group Medical Insurance.

CASE_PARTICIPANT_ROLE_ID SVR_INT64
insCaseParticipantRoleIDdetailsno

The Case Participant Role ID of the insurance company that provides the Medical Insurance.

CASE_PARTICIPANT_ROLE_ID SVR_INT64
medicalInsuranceTypedetails 

A code table value describing the type of Medical Insurance policy. Examples include: Major Medical, Basic Hospital/Surgical, Accident, Indemnity, Nursing Home, Medicare Supplement and Hospital Outpatient.

EVD_MEDICAL_INSURANCE_TYPEMedicalInsuranceTypeSVR_STRING<10>
policyStartDatedetails 

The date on which coverage begins under the policy.

CURAM_DATE SVR_DATE
policyEndDatedetails 

The date on which coverage ends under the policy.

CURAM_DATE SVR_DATE
premiumdetails 

The amount payable for the Medical Insurance cover.

CURAM_AMOUNT SVR_MONEY
frequencyCodedetails 

The frequency at which the insurance premium is paid.

FREQUENCY_CODE_STATICFrequencyCodeSVR_STRING<10>
commentsdetails 

Details related to the Medical Insurance.

COMMENTS SVR_STRING<300>
deductibledetails 

A deductible is the amount which must be paid before the insurance company begins to pay medical bills. This is an annual amount per insured person.

CURAM_AMOUNT SVR_MONEY
maxDeductibledetails 

This is the monetary value of the maximum deductible paid per household per year.

CURAM_AMOUNT SVR_MONEY
stateOfCoveragedetails 

Drop down list containing US States.

EVD_ADDRESS_STATEAddressStateSVR_STRING<10>
countryWideCoveragedetails 

Indicator to show whether coverage under the Medical Insurance policy applies Country wide.

CURAM_INDICATOR SVR_BOOLEAN
Foreign Keys (1)
ChildParent
MedicalInsurance.plchdrCaseParticipantRoleIDCaseParticipantRole.caseParticipantRoleID
Indices (1)
Index NameAttributes
IND_790294415plchdrCaseParticipantRoleID
Operations (5)
OperationStereotypeOptionsDescriptionSQL
insertinsertAUTO_ID: evidenceID
PRE_DATA_ACCESS: yes
Standard Operation 
readread Standard Operation 
modifymodifyOPTIMISTIC_LOCKING: yes
PRE_DATA_ACCESS: yes
Standard Operation 
readCaseParticipantsByEvidenceIDnsread Returns all related caseParticipantRoleID's for a specified evidenceID. 
transferEvidence    
Related Pages (14)