Entity MedClaimHistory

Description of Entity MedClaimHistory

Shows the medical history of the employee. This is for recording the types of illness an employee has had before. Only one record of each type of illness can be stored. However, you can upload multiple documents for each record.


List of all Dependencies of the Entity MedClaimHistory

Name

Code

Class Name

Relation_252841

Relation_252841

Reference


List of Attributes of the Entity MedClaimHistory

Name

Code

Medical Claim Policy ID

MClaimPolicyId

MClaimPolicyBasisValue

MClaimPolicyBasisValue

MClaimTypeBasisValue

MClaimTypeBasisValue

From

MedClaimCycleStart

To

MedClaimCycleEnd

Amount Limit Per Claim

LimitPerClaim

Limit Per Cycle

LimitPerCycle

Limit No of Claims per Policy

LimitPerPolicy

Co Payment Type (Company)

CoPaymentType

Percentage or Fixed Amount

CoPaymentAmtPercent

Company expected to pay

MedClaimCompanyPay

Employee expected to pay

MedClaimEmployeePay

No Limit per Policy

NoLimitPerPolicy


Entity Attribute Medical Claim Policy ID of the Entity MedClaimHistory

Card of Attribute Medical Claim Policy ID of the Entity MedClaimHistory

Name

Medical Claim Policy ID

Code

MClaimPolicyId

Data Type

char(20)

Mandatory

No


Description of Attribute Medical Claim Policy ID of the Entity MedClaimHistory

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


Entity Attribute MClaimPolicyBasisValue of the Entity MedClaimHistory

Card of Attribute MClaimPolicyBasisValue of the Entity MedClaimHistory

Name

MClaimPolicyBasisValue

Code

MClaimPolicyBasisValue

Data Type

char(20)

Mandatory

No


Description of Attribute MClaimPolicyBasisValue of the Entity MedClaimHistory

Shows the basis value for the medical claim policy.


Entity Attribute MClaimTypeBasisValue of the Entity MedClaimHistory

Card of Attribute MClaimTypeBasisValue of the Entity MedClaimHistory

Name

MClaimTypeBasisValue

Code

MClaimTypeBasisValue

Data Type

char(20)

Mandatory

No


Description of Attribute MClaimTypeBasisValue of the Entity MedClaimHistory

Shows the basis value for the medical claim type.


Entity Attribute From of the Entity MedClaimHistory

Card of Attribute From of the Entity MedClaimHistory

Name

From

Code

MedClaimCycleStart

Data Type

date

Mandatory

No


Description of Attribute From of the Entity MedClaimHistory

Shows the starting date for the medical claim cycle.
It is in the format: DD-MM-YYYY.


Entity Attribute To of the Entity MedClaimHistory

Card of Attribute To of the Entity MedClaimHistory

Name

To

Code

MedClaimCycleEnd

Data Type

date

Mandatory

No


Description of Attribute To of the Entity MedClaimHistory

Shows the end date of the medical claim cycle.
It is in the format: DD-MM-YYYY.


Entity Attribute Amount Limit Per Claim of the Entity MedClaimHistory

Card of Attribute Amount Limit Per Claim of the Entity MedClaimHistory

Name

Amount Limit Per Claim

Code

LimitPerClaim

Data Type

double

Mandatory

No


Description of Attribute Amount Limit Per Claim of the Entity MedClaimHistory

Shows the amount limit per claim. (Zero is for no limit)


Entity Attribute Limit Per Cycle of the Entity MedClaimHistory

Card of Attribute Limit Per Cycle of the Entity MedClaimHistory

Name

Limit Per Cycle

Code

LimitPerCycle

Data Type

double

Mandatory

No


Description of Attribute Limit Per Cycle of the Entity MedClaimHistory

Shows the limit per cycle.
Example: Fixed / Factor


Entity Attribute Limit No of Claims per Policy of the Entity MedClaimHistory

Card of Attribute Limit No of Claims per Policy of the Entity MedClaimHistory

Name

Limit No of Claims per Policy

Code

LimitPerPolicy

Data Type

double

Mandatory

No


Description of Attribute Limit No of Claims per Policy of the Entity MedClaimHistory

Shows the limited number of claims per policy, in a form of a checkbox. Each approved claim amount is deducted from this.
Example: An amount of '1000' is set here and an employee submits 3 medical claims, each 35.71, the balance would be 892.87, i.e. 1000-(35.71x3).

When the limit is reached, no more claim submissions can be submitted for this employee, regardless of the number of submissions remaining. If you have the ePortal application, each time a claim is submitted, the policy limits are checked and if exceeded, an error message is displayed. The employee would then be prevented from submitting a claim.


Entity Attribute Co Payment Type (Company) of the Entity MedClaimHistory

Card of Attribute Co Payment Type (Company) of the Entity MedClaimHistory

Name

Co Payment Type (Company)

Code

CoPaymentType

Data Type

smallint

Mandatory

No


Description of Attribute Co Payment Type (Company) of the Entity MedClaimHistory

Shows the payment type, in a form of radio buttons.
Example: No Co Payment / Percentage / Fixed Amount


Entity Attribute Percentage or Fixed Amount of the Entity MedClaimHistory

Card of Attribute Percentage or Fixed Amount of the Entity MedClaimHistory

Name

Percentage or Fixed Amount

Code

CoPaymentAmtPercent

Data Type

double

Mandatory

No


Description of Attribute Percentage or Fixed Amount of the Entity MedClaimHistory

Shows the percentage/amount of the co payment. It will appear if you have chosen the Percentage / Fixed Amount radio button from the CoPaymentType attribute.


Entity Attribute Company expected to pay of the Entity MedClaimHistory

Card of Attribute Company expected to pay of the Entity MedClaimHistory

Name

Company expected to pay

Code

MedClaimCompanyPay

Data Type

double

Mandatory

No


Description of Attribute Company expected to pay of the Entity MedClaimHistory

Shows the amount the company is expected to pay for the medical claim.


Entity Attribute Employee expected to pay of the Entity MedClaimHistory

Card of Attribute Employee expected to pay of the Entity MedClaimHistory

Name

Employee expected to pay

Code

MedClaimEmployeePay

Data Type

double

Mandatory

No


Description of Attribute Employee expected to pay of the Entity MedClaimHistory

Shows the amount the employee is expected to pay for the medical claim.


Entity Attribute No Limit per Policy of the Entity MedClaimHistory

Card of Attribute No Limit per Policy of the Entity MedClaimHistory

Name

No Limit per Policy

Code

NoLimitPerPolicy

Data Type

integer

Mandatory

No


Description of Attribute No Limit per Policy of the Entity MedClaimHistory

Shows that there is no limit per policy for the medical claim.