Entity MClaimPolicy

Description of Entity MClaimPolicy

A medical policy determines which type of claims an employee is able to submit and for how much. An employee can have more than 1 medical policy. If you are going to assign more than 1 policy to an employee, then you should check that each of the medical policies do not contain the same medical claim type, otherwise an error will result and you are prevented from doing so.

Any medical claim policy can be assigned, but certain rules apply:
- The medical policies cannot contain the medical claim type
- The eligibility of the medical claim policy and the medical type are applicable

You can take advantage of the first rule when creating complementary or mutually exclusive packages by including or excluding a medical claim type. The eligibility that the second rule refers to is the range basis at the policy level and the claim level.


List of all Dependencies of the Entity MClaimPolicy

Name

Code

Class Name

Relation_244177

Relation_244177

Reference

Relation_244178

Relation_244178

Reference

Relation_244193

Relation_244193

Reference

Relation_648516

Relation_648516

Reference


List of Attributes of the Entity MClaimPolicy

Name

Code

Medical Claim Policy ID

MedClaimPolicyId

Description

MedClaimPolicyDesc

MedClaimPolicyBasis

MedClaimPolicyBasis

Date Base On

MedClaimDateBasis


Entity Attribute Medical Claim Policy ID of the Entity MClaimPolicy

Card of Attribute Medical Claim Policy ID of the Entity MClaimPolicy

Name

Medical Claim Policy ID

Code

MedClaimPolicyId

Data Type

char(20)

Mandatory

Yes


Description of Attribute Medical Claim Policy ID of the Entity MClaimPolicy

Shows the identity of the medical claim policy. It also acts as a primary key for the MClaimPolicy table.
Example: Co. Medical Policy


Entity Attribute Description of the Entity MClaimPolicy

Card of Attribute Description of the Entity MClaimPolicy

Name

Description

Code

MedClaimPolicyDesc

Data Type

char(100)

Mandatory

No


Description of Attribute Description of the Entity MClaimPolicy

Stores any description about the medical claim policy.
Example: Company Medical Policy


Entity Attribute MedClaimPolicyBasis of the Entity MClaimPolicy

Card of Attribute MedClaimPolicyBasis of the Entity MClaimPolicy

Name

MedClaimPolicyBasis

Code

MedClaimPolicyBasis

Data Type

char(20)

Mandatory

No


Description of Attribute MedClaimPolicyBasis of the Entity MClaimPolicy

Shows the basis for the medical claim policy.


Entity Attribute Date Base On of the Entity MClaimPolicy

Card of Attribute Date Base On of the Entity MClaimPolicy

Name

Date Base On

Code

MedClaimDateBasis

Data Type

smallint

Mandatory

No


Description of Attribute Date Base On of the Entity MClaimPolicy

Indicates what date the medical claim policy is based on, in a form of radio buttons.
Example: Submission / Receipt