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Uses the VbapiClient helper described in /developer-portal/concepts/requests-and-responses.\nrequest = {\n    \"user_ID\": os.environ[\"VBAPI_USERNAME\"],  # the user the request runs on behalf of\n    \"subscriber_ID\": SUBSCRIBER_ID,\n    \"member_Seq\": MEMBER_SEQ,\n    \"subscriber\": False,  # true only when MEMBER_SEQ is the insured (the subscriber)\n    # Copied from the current SubEnrollment record:\n    \"group_ID\": current[\"group_ID\"],\n    \"division_ID\": current[\"division_ID\"],\n    \"group_Coverage_Start\": current[\"group_Coverage_Start\"],\n    \"start_Date\": current[\"start_Date\"],\n    \"disenroll_Date\": DISENROLL_DATE,\n    \"term_Date\": DISENROLL_DATE,  # informational only\n    \"reason_ID\": REASON_ID,\n    \"disenrollFamily\": DISENROLL_MEMBER,\n    \"disenrollFuture\": DISENROLL_FUTURE,\n    \"terminateAuth\": True,  # cancel auths approved or requested beyond the disenroll date\n    \"premRates\": [],  # send empty lists, not null\n    \"premInvoiceAdjustments\": [],\n}\nprocess = api.post(f\"/subscribers/{SUBSCRIBER_ID}/members/{MEMBER_SEQ}/disenroll\", request).data\nprint(f\"VBAProcess {process['vbaProcess_Key']} ({process['vbaProcess_Type']}): \"\n      f\"result={process.get('process_Result')} ended={process.get('process_End')}\")\n"},{"lang":"Node.js","label":"TypeScript","source":"// From the Disenroll a member or group playbook. 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The x-api-key header is missing or not valid. The API gateway sends this response, not VBAPI, so the body is not the VBAPI envelope; see Errors and troubleshooting."},{"code":"429","description":"Too many requests. The limit is 25 requests per second sustained, with bursts up to 50, per API key. Wait and retry with exponential backoff and jitter."}],"pointer":"/paths/~1subscribers~1{subscriberID}~1members~1{memberSeq}~1disenroll/post/responses"}],"panels":[{"children":[{"kind":"response","responseCodes":[{"code":"200","schemaId":"components/schemas/VBAProcessVBAResponse","mediaTypes":["application/json"],"mediaTypeContent":{"application/json":{"schemaId":"components/schemas/VBAProcessVBAResponse"}}},{"code":"401"},{"code":"403"},{"code":"429"}],"examples":[]}]}]}]},"httpPath":"/subscribers/{subscriberID}/members/{memberSeq}/disenroll"},{"label":"List Billing Adjustments for Disenroll","deprecated":false,"httpVerb":"get","isAdditionalOperation":false,"isWebhook":false,"type":"link","link":"/openapi/vbasoftware/vbasoftware.api/adv.-enrollment/listdisenrolladjustment","routeSlug":"/openapi/vbasoftware/vbasoftware.api/adv.-enrollment/listdisenrolladjustment","metadata":{"seo":{"title":"List Billing Adjustments for Disenroll","description":"List of Billing Adjustments that would be created based on a Subscriber being disenrolled on the As of Date."}},"content":{"contentType":"item","itemVariant":"httpItem","meta":{"sourceId":"ListDisenrollAdjustment","name":"List Billing Adjustments for Disenroll","isWebhook":false,"pointer":"/paths/~1subscribers~1{subscriberID}~1as-of-date~1{asOfDate}~1disenroll-adjustments/get","hasSamples":false},"children":[{"nodeType":"container","children":[{"nodeType":"header","level":2,"label":"List Billing Adjustments for Disenroll","isWebhook":false,"showPageActions":true}],"panels":[]},{"nodeType":"container","children":[{"nodeType":"header","level":4,"label":"Request","labelTranslationKey":"request","deepLinkSuffix":"request"},{"nodeType":"markdoc","content":"List of Billing Adjustments that would be created based on a Subscriber being disenrolled on the As of Date."},{"nodeType":"security","requirements":[{"schemes":[{"name":"apiKeyAuth","scopes":[],"type":"apiKey","in":"header","paramName":"x-api-key","description":"Input apikey to access this API"},{"name":"bearerAuth","scopes":[],"type":"http","scheme":"bearer","bearerFormat":"JWT","description":"Input bearer token to access this API"}]}]},{"nodeType":"item-content","variant":"path","label":"Path","labelTranslationKey":"path","parameters":[{"name":"subscriberID","in":"path","schemaId":"schema_0","description":"Subscriber ID","required":true},{"name":"asOfDate","in":"path","schemaId":"schema_39","description":"As of Date","required":true}],"pointer":"/paths/~1subscribers~1{subscriberID}~1as-of-date~1{asOfDate}~1disenroll-adjustments/get/parameters"},{"nodeType":"item-content","variant":"headers","label":"Headers","labelTranslationKey":"header","parameters":[{"name":"vbasoftware-database","in":"header","schemaId":"schema_0","description":"Target database","required":true}],"pointer":"/paths/~1subscribers~1{subscriberID}~1as-of-date~1{asOfDate}~1disenroll-adjustments/get/parameters"}],"panels":[{"children":[{"kind":"code-sample","source":{"kind":"code-sample","operationType":"http","method":"GET","path":"/subscribers/{subscriberID}/as-of-date/{asOfDate}/disenroll-adjustments","servers":[{"url":"https://vbapi.vbasoftware.com/vbasoftware","description":"VBAPI production"}],"parameters":{"path":[{"name":"subscriberID","in":"path","required":true,"schemaId":"schema_0"},{"name":"asOfDate","in":"path","required":true,"schemaId":"schema_39"}],"query":[],"querystring":[],"header":[{"name":"vbasoftware-database","in":"header","required":true,"schemaId":"schema_0"}],"cookie":[]},"security":[{"schemes":[{"id":"apiKeyAuth","type":"apiKey","name":"x-api-key","in":"header"},{"id":"bearerAuth","type":"http","scheme":"bearer","bearerFormat":"JWT"}],"scopes":[]}],"responseCodes":["200","401","403","429"],"pointer":"/subscribers/{subscriberID}/as-of-date/{asOfDate}/disenroll-adjustments","href":"adv.-enrollment/listdisenrolladjustment","openApiOperationId":"ListDisenrollAdjustment","summary":"List Billing Adjustments for Disenroll"},"isWebhook":false,"hideReplay":false,"servers":[{"url":"https://vbapi.vbasoftware.com/vbasoftware","description":"VBAPI production"}],"examples":[]}]}]},{"nodeType":"container","children":[{"nodeType":"header","level":4,"label":"Responses","labelTranslationKey":"responses","deepLinkSuffix":"responses"},{"nodeType":"item-content","variant":"responses","responses":[{"code":"200","description":"Success","mediaType":"application/json","mediaTypes":["application/json"],"mediaTypeContent":{"application/json":{"schemaId":"components/schemas/EnrollmentDisenrollAdjustmentListVBAResponse"}},"schemaId":"components/schemas/EnrollmentDisenrollAdjustmentListVBAResponse"},{"code":"401","description":"Unauthorized"},{"code":"403","description":"Forbidden. The x-api-key header is missing or not valid. The API gateway sends this response, not VBAPI, so the body is not the VBAPI envelope; see Errors and troubleshooting."},{"code":"429","description":"Too many requests. The limit is 25 requests per second sustained, with bursts up to 50, per API key. Wait and retry with exponential backoff and jitter."}],"pointer":"/paths/~1subscribers~1{subscriberID}~1as-of-date~1{asOfDate}~1disenroll-adjustments/get/responses"}],"panels":[{"children":[{"kind":"response","responseCodes":[{"code":"200","schemaId":"components/schemas/EnrollmentDisenrollAdjustmentListVBAResponse","mediaTypes":["application/json"],"mediaTypeContent":{"application/json":{"schemaId":"components/schemas/EnrollmentDisenrollAdjustmentListVBAResponse"}}},{"code":"401"},{"code":"403"},{"code":"429"}],"examples":[]}]}]}]},"httpPath":"/subscribers/{subscriberID}/as-of-date/{asOfDate}/disenroll-adjustments"},{"label":"List Waiting Period Details","deprecated":false,"httpVerb":"get","isAdditionalOperation":false,"isWebhook":false,"type":"link","link":"/openapi/vbasoftware/vbasoftware.api/adv.-enrollment/listenrollmentwaitingperiodbyhiredate","routeSlug":"/openapi/vbasoftware/vbasoftware.api/adv.-enrollment/listenrollmentwaitingperiodbyhiredate","metadata":{"seo":{"title":"List Waiting Period Details","description":"List of Waiting Period configuration based on the passed in settings (group, division, plan, and/or hire date)."}},"content":{"contentType":"item","itemVariant":"httpItem","meta":{"sourceId":"ListEnrollmentWaitingPeriodByHireDate","name":"List Waiting Period Details","isWebhook":false,"pointer":"/paths/~1enrollment-waiting-period-by-hire-date/get","hasSamples":false},"children":[{"nodeType":"container","children":[{"nodeType":"header","level":2,"label":"List Waiting Period Details","isWebhook":false,"showPageActions":true}],"panels":[]},{"nodeType":"container","children":[{"nodeType":"header","level":4,"label":"Request","labelTranslationKey":"request","deepLinkSuffix":"request"},{"nodeType":"markdoc","content":"List of Waiting Period configuration based on the passed in settings (group, division, plan, and/or hire date)."},{"nodeType":"security","requirements":[{"schemes":[{"name":"apiKeyAuth","scopes":[],"type":"apiKey","in":"header","paramName":"x-api-key","description":"Input apikey to access this API"},{"name":"bearerAuth","scopes":[],"type":"http","scheme":"bearer","bearerFormat":"JWT","description":"Input bearer token to access this API"}]}]},{"nodeType":"item-content","variant":"query","label":"Query","labelTranslationKey":"query","parameters":[{"name":"groupID","in":"query","schemaId":"schema_0","description":"Group ID"},{"name":"divisionID","in":"query","schemaId":"schema_0","description":"Division ID"},{"name":"planID","in":"query","schemaId":"schema_0","description":"Plan ID"},{"name":"hireDate","in":"query","schemaId":"schema_39","description":"Hire Date"}],"pointer":"/paths/~1enrollment-waiting-period-by-hire-date/get/parameters"},{"nodeType":"item-content","variant":"headers","label":"Headers","labelTranslationKey":"header","parameters":[{"name":"vbasoftware-database","in":"header","schemaId":"schema_0","description":"Target database","required":true}],"pointer":"/paths/~1enrollment-waiting-period-by-hire-date/get/parameters"}],"panels":[{"children":[{"kind":"code-sample","source":{"kind":"code-sample","operationType":"http","method":"GET","path":"/enrollment-waiting-period-by-hire-date","servers":[{"url":"https://vbapi.vbasoftware.com/vbasoftware","description":"VBAPI production"}],"parameters":{"path":[],"query":[{"name":"groupID","in":"query","schemaId":"schema_0"},{"name":"divisionID","in":"query","schemaId":"schema_0"},{"name":"planID","in":"query","schemaId":"schema_0"},{"name":"hireDate","in":"query","schemaId":"schema_39"}],"querystring":[],"header":[{"name":"vbasoftware-database","in":"header","required":true,"schemaId":"schema_0"}],"cookie":[]},"security":[{"schemes":[{"id":"apiKeyAuth","type":"apiKey","name":"x-api-key","in":"header"},{"id":"bearerAuth","type":"http","scheme":"bearer","bearerFormat":"JWT"}],"scopes":[]}],"responseCodes":["200","401","403","429"],"pointer":"/enrollment-waiting-period-by-hire-date","href":"adv.-enrollment/listenrollmentwaitingperiodbyhiredate","openApiOperationId":"ListEnrollmentWaitingPeriodByHireDate","summary":"List Waiting Period Details"},"isWebhook":false,"hideReplay":false,"servers":[{"url":"https://vbapi.vbasoftware.com/vbasoftware","description":"VBAPI production"}],"examples":[]}]}]},{"nodeType":"container","children":[{"nodeType":"header","level":4,"label":"Responses","labelTranslationKey":"responses","deepLinkSuffix":"responses"},{"nodeType":"item-content","variant":"responses","responses":[{"code":"200","description":"Success","mediaType":"application/json","mediaTypes":["application/json"],"mediaTypeContent":{"application/json":{"schemaId":"components/schemas/EnrollmentWaitingPeriodByHireDateListVBAResponse"}},"schemaId":"components/schemas/EnrollmentWaitingPeriodByHireDateListVBAResponse"},{"code":"401","description":"Unauthorized"},{"code":"403","description":"Forbidden. The x-api-key header is missing or not valid. The API gateway sends this response, not VBAPI, so the body is not the VBAPI envelope; see Errors and troubleshooting."},{"code":"429","description":"Too many requests. The limit is 25 requests per second sustained, with bursts up to 50, per API key. Wait and retry with exponential backoff and jitter."}],"pointer":"/paths/~1enrollment-waiting-period-by-hire-date/get/responses"}],"panels":[{"children":[{"kind":"response","responseCodes":[{"code":"200","schemaId":"components/schemas/EnrollmentWaitingPeriodByHireDateListVBAResponse","mediaTypes":["application/json"],"mediaTypeContent":{"application/json":{"schemaId":"components/schemas/EnrollmentWaitingPeriodByHireDateListVBAResponse"}}},{"code":"401"},{"code":"403"},{"code":"429"}],"examples":[]}]}]}]},"httpPath":"/enrollment-waiting-period-by-hire-date"},{"label":"Member Re-enroll","deprecated":false,"httpVerb":"post","isAdditionalOperation":false,"isWebhook":false,"type":"link","link":"/openapi/vbasoftware/vbasoftware.api/adv.-enrollment/memberreenroll","routeSlug":"/openapi/vbasoftware/vbasoftware.api/adv.-enrollment/memberreenroll","metadata":{"seo":{"title":"Member Re-enroll","description":"Re-enrolls a Member to an Enrollment. A VBAProcess object is returned representing the process state. See VBAProcess area for more information."}},"content":{"contentType":"item","itemVariant":"httpItem","meta":{"sourceId":"MemberReenroll","name":"Member Re-enroll","isWebhook":false,"pointer":"/paths/~1subscribers~1{subscriberID}~1members~1{memberSeq}~1reenroll/post","hasSamples":true},"children":[{"nodeType":"container","children":[{"nodeType":"header","level":2,"label":"Member Re-enroll","isWebhook":false,"showPageActions":true}],"panels":[]},{"nodeType":"container","children":[{"nodeType":"header","level":4,"label":"Request","labelTranslationKey":"request","deepLinkSuffix":"request"},{"nodeType":"markdoc","content":"Re-enrolls a Member to an Enrollment.  A VBAProcess object is returned representing the process state. See VBAProcess area for more information."},{"nodeType":"security","requirements":[{"schemes":[{"name":"apiKeyAuth","scopes":[],"type":"apiKey","in":"header","paramName":"x-api-key","description":"Input apikey to access this API"},{"name":"bearerAuth","scopes":[],"type":"http","scheme":"bearer","bearerFormat":"JWT","description":"Input bearer token to access this API"}]}]},{"nodeType":"item-content","variant":"path","label":"Path","labelTranslationKey":"path","parameters":[{"name":"subscriberID","in":"path","schemaId":"schema_0","description":"Subscriber ID","required":true},{"name":"memberSeq","in":"path","schemaId":"schema_0","description":"Member Seq","required":true}],"pointer":"/paths/~1subscribers~1{subscriberID}~1members~1{memberSeq}~1reenroll/post/parameters"},{"nodeType":"item-content","variant":"headers","label":"Headers","labelTranslationKey":"header","parameters":[{"name":"vbasoftware-database","in":"header","schemaId":"schema_0","description":"Target database","required":true}],"pointer":"/paths/~1subscribers~1{subscriberID}~1members~1{memberSeq}~1reenroll/post/parameters"},{"nodeType":"item-content","variant":"body","label":"Request Body","labelTranslationKey":"body","required":true,"mediaTypes":["application/json"],"mediaTypeSchemas":{"application/json":{"schemaId":"components/schemas/EnrollmentReenroll"}},"schemaId":"components/schemas/EnrollmentReenroll","pointer":"/paths/~1subscribers~1{subscriberID}~1members~1{memberSeq}~1reenroll/post/requestBody"}],"panels":[{"children":[{"kind":"code-sample","source":{"kind":"code-sample","operationType":"http","method":"POST","path":"/subscribers/{subscriberID}/members/{memberSeq}/reenroll","servers":[{"url":"https://vbapi.vbasoftware.com/vbasoftware","description":"VBAPI production"}],"parameters":{"path":[{"name":"subscriberID","in":"path","required":true,"schemaId":"schema_0"},{"name":"memberSeq","in":"path","required":true,"schemaId":"schema_0"}],"query":[],"querystring":[],"header":[{"name":"vbasoftware-database","in":"header","required":true,"schemaId":"schema_0"}],"cookie":[]},"security":[{"schemes":[{"id":"apiKeyAuth","type":"apiKey","name":"x-api-key","in":"header"},{"id":"bearerAuth","type":"http","scheme":"bearer","bearerFormat":"JWT"}],"scopes":[]}],"requestBody":{"application/json":{"schemaId":"components/schemas/EnrollmentReenroll"}},"responseCodes":["200","401","403","429"],"pointer":"/subscribers/{subscriberID}/members/{memberSeq}/reenroll","href":"adv.-enrollment/memberreenroll","openApiOperationId":"MemberReenroll","summary":"Member Re-enroll"},"isWebhook":false,"hideReplay":false,"servers":[{"url":"https://vbapi.vbasoftware.com/vbasoftware","description":"VBAPI production"}],"schemaId":"components/schemas/EnrollmentReenroll","mediaTypes":["application/json"],"mediaTypeSchemas":{"application/json":{"schemaId":"components/schemas/EnrollmentReenroll"}},"examples":[]}]}]},{"nodeType":"container","children":[{"nodeType":"header","level":4,"label":"Responses","labelTranslationKey":"responses","deepLinkSuffix":"responses"},{"nodeType":"item-content","variant":"responses","responses":[{"code":"200","description":"Success","mediaType":"application/json","mediaTypes":["application/json"],"mediaTypeContent":{"application/json":{"schemaId":"components/schemas/VBAProcessVBAResponse"}},"schemaId":"components/schemas/VBAProcessVBAResponse"},{"code":"401","description":"Unauthorized"},{"code":"403","description":"Forbidden. The x-api-key header is missing or not valid. The API gateway sends this response, not VBAPI, so the body is not the VBAPI envelope; see Errors and troubleshooting."},{"code":"429","description":"Too many requests. The limit is 25 requests per second sustained, with bursts up to 50, per API key. Wait and retry with exponential backoff and jitter."}],"pointer":"/paths/~1subscribers~1{subscriberID}~1members~1{memberSeq}~1reenroll/post/responses"}],"panels":[{"children":[{"kind":"response","responseCodes":[{"code":"200","schemaId":"components/schemas/VBAProcessVBAResponse","mediaTypes":["application/json"],"mediaTypeContent":{"application/json":{"schemaId":"components/schemas/VBAProcessVBAResponse"}}},{"code":"401"},{"code":"403"},{"code":"429"}],"examples":[]}]}]}]},"httpPath":"/subscribers/{subscriberID}/members/{memberSeq}/reenroll"},{"label":"Subscriber Add Enrollment","deprecated":false,"httpVerb":"post","isAdditionalOperation":false,"isWebhook":false,"type":"link","link":"/openapi/vbasoftware/vbasoftware.api/adv.-enrollment/subscriberaddenrollment","routeSlug":"/openapi/vbasoftware/vbasoftware.api/adv.-enrollment/subscriberaddenrollment","metadata":{"seo":{"title":"Subscriber Add Enrollment","description":"Adds enrollments to an existing subscriber. Can add enrollment for the subscriber or subscriber + all members."}},"content":{"contentType":"item","itemVariant":"httpItem","meta":{"sourceId":"SubscriberAddEnrollment","name":"Subscriber Add Enrollment","isWebhook":false,"pointer":"/paths/~1subscribers~1{subscriberID}~1add-enrollment/post","hasSamples":true},"children":[{"nodeType":"container","children":[{"nodeType":"header","level":2,"label":"Subscriber Add Enrollment","isWebhook":false,"showPageActions":true}],"panels":[]},{"nodeType":"container","children":[{"nodeType":"header","level":4,"label":"Request","labelTranslationKey":"request","deepLinkSuffix":"request"},{"nodeType":"markdoc","content":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Adds enrollments to an existing subscriber. Can add enrollment for the subscriber or subscriber + all members."},"children":[]}]}]}]},{"nodeType":"security","requirements":[{"schemes":[{"name":"apiKeyAuth","scopes":[],"type":"apiKey","in":"header","paramName":"x-api-key","description":"Input apikey to access this API"},{"name":"bearerAuth","scopes":[],"type":"http","scheme":"bearer","bearerFormat":"JWT","description":"Input bearer token to access this API"}]}]},{"nodeType":"item-content","variant":"path","label":"Path","labelTranslationKey":"path","parameters":[{"name":"subscriberID","in":"path","schemaId":"schema_0","description":"Subscriber ID","required":true}],"pointer":"/paths/~1subscribers~1{subscriberID}~1add-enrollment/post/parameters"},{"nodeType":"item-content","variant":"headers","label":"Headers","labelTranslationKey":"header","parameters":[{"name":"vbasoftware-database","in":"header","schemaId":"schema_0","description":"Target database","required":true}],"pointer":"/paths/~1subscribers~1{subscriberID}~1add-enrollment/post/parameters"},{"nodeType":"item-content","variant":"body","label":"Request Body","labelTranslationKey":"body","required":true,"mediaTypes":["application/json"],"mediaTypeSchemas":{"application/json":{"schemaId":"components/schemas/AddEnrollmentRequest"}},"schemaId":"components/schemas/AddEnrollmentRequest","pointer":"/paths/~1subscribers~1{subscriberID}~1add-enrollment/post/requestBody"}],"panels":[{"children":[{"kind":"code-sample","source":{"kind":"code-sample","operationType":"http","method":"POST","path":"/subscribers/{subscriberID}/add-enrollment","servers":[{"url":"https://vbapi.vbasoftware.com/vbasoftware","description":"VBAPI production"}],"parameters":{"path":[{"name":"subscriberID","in":"path","required":true,"schemaId":"schema_0"}],"query":[],"querystring":[],"header":[{"name":"vbasoftware-database","in":"header","required":true,"schemaId":"schema_0"}],"cookie":[]},"security":[{"schemes":[{"id":"apiKeyAuth","type":"apiKey","name":"x-api-key","in":"header"},{"id":"bearerAuth","type":"http","scheme":"bearer","bearerFormat":"JWT"}],"scopes":[]}],"requestBody":{"application/json":{"schemaId":"components/schemas/AddEnrollmentRequest"}},"responseCodes":["202","401","403","429"],"pointer":"/subscribers/{subscriberID}/add-enrollment","href":"adv.-enrollment/subscriberaddenrollment","openApiOperationId":"SubscriberAddEnrollment","summary":"Subscriber Add Enrollment"},"definitionSamples":[{"lang":"C#","label":"C#","source":"// From the Enroll employees and dependents playbook. Uses the VbapiClient helper described in /developer-portal/concepts/requests-and-responses.\nif (await FindEnrollmentAsync(api, coverageStart) is not null)\n{\n    Console.WriteLine($\"Already enrolled in {GroupId} {DivisionId} {coverageStart}\");\n}\nelse\n{\n    var response = await api.PostAsync($\"/subscribers/{SubscriberId}/add-enrollment\", new\n    {\n        requesting_User_ID = requestingUserId,\n        addMembers = true,\n        subEnrollment = new\n        {\n            subscriber_ID = SubscriberId,\n            group_ID = GroupId,\n            division_ID = DivisionId,\n            group_Coverage_Start = $\"{coverageStart}T00:00:00\",\n            start_Date = $\"{coverageStart}T00:00:00\",\n            end_Date = $\"{coverageEnd}T00:00:00\",\n        },\n    });\n    Console.WriteLine($\"add-enrollment returned {(int)response.Status}\"); // 202 Accepted, no body\n}\n"},{"lang":"Python","label":"Python","source":"# From the Enroll employees and dependents playbook. Uses the VbapiClient helper described in /developer-portal/concepts/requests-and-responses.\nif find_enrollment():\n    print(\"Already enrolled in\", GROUP_ID, DIVISION_ID, coverage_start)\nelse:\n    response = api.post(f\"/subscribers/{SUBSCRIBER_ID}/add-enrollment\", {\n        \"requesting_User_ID\": REQUESTING_USER_ID,\n        \"addMembers\": True,\n        \"subEnrollment\": {\n            \"subscriber_ID\": SUBSCRIBER_ID,\n            \"group_ID\": GROUP_ID,\n            \"division_ID\": DIVISION_ID,\n            \"group_Coverage_Start\": f\"{coverage_start}T00:00:00\",\n            \"start_Date\": f\"{coverage_start}T00:00:00\",\n            \"end_Date\": f\"{coverage_end}T00:00:00\",\n        },\n    })\n    print(\"add-enrollment returned\", response.status)  # 202 Accepted, no body\n"},{"lang":"Node.js","label":"TypeScript","source":"// From the Enroll employees and dependents playbook. 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The x-api-key header is missing or not valid. The API gateway sends this response, not VBAPI, so the body is not the VBAPI envelope; see Errors and troubleshooting."},{"code":"429","description":"Too many requests. The limit is 25 requests per second sustained, with bursts up to 50, per API key. Wait and retry with exponential backoff and jitter."}],"pointer":"/paths/~1groups~1{groupID}~1divisions~1{divisionID}~1copy/post/responses"}],"panels":[{"children":[{"kind":"response","responseCodes":[{"code":"200","schemaId":"components/schemas/GroupDivisionVBAResponse","mediaTypes":["application/json"],"mediaTypeContent":{"application/json":{"schemaId":"components/schemas/GroupDivisionVBAResponse"}}},{"code":"401"},{"code":"403"},{"code":"429"}],"examples":[]}]}]}]},"httpPath":"/groups/{groupID}/divisions/{divisionID}/copy"},{"label":"Get Group enrollment summary information","deprecated":false,"httpVerb":"get","isAdditionalOperation":false,"isWebhook":false,"type":"link","link":"/openapi/vbasoftware/vbasoftware.api/adv.-group-divisions/getgroupdivisionenrollmentsummary","routeSlug":"/openapi/vbasoftware/vbasoftware.api/adv.-group-divisions/getgroupdivisionenrollmentsummary","metadata":{"seo":{"title":"Get Group enrollment summary information","description":"Gets enrollment summary for the given group id and division id."}},"content":{"contentType":"item","itemVariant":"httpItem","meta":{"sourceId":"GetGroupDivisionEnrollmentSummary","name":"Get Group enrollment summary information","isWebhook":false,"pointer":"/paths/~1groups~1{groupID}~1divisions~1{divisionID}~1enrollment-summary/get","hasSamples":false},"children":[{"nodeType":"container","children":[{"nodeType":"header","level":2,"label":"Get Group enrollment summary information","isWebhook":false,"showPageActions":true}],"panels":[]},{"nodeType":"container","children":[{"nodeType":"header","level":4,"label":"Request","labelTranslationKey":"request","deepLinkSuffix":"request"},{"nodeType":"markdoc","content":"Gets enrollment summary for the given group id and division id. "},{"nodeType":"security","requirements":[{"schemes":[{"name":"apiKeyAuth","scopes":[],"type":"apiKey","in":"header","paramName":"x-api-key","description":"Input apikey to access this API"},{"name":"bearerAuth","scopes":[],"type":"http","scheme":"bearer","bearerFormat":"JWT","description":"Input bearer token to access this API"}]}]},{"nodeType":"item-content","variant":"path","label":"Path","labelTranslationKey":"path","parameters":[{"name":"groupID","in":"path","schemaId":"schema_0","description":"Group ID","required":true},{"name":"divisionID","in":"path","schemaId":"schema_0","description":"Division ID","required":true}],"pointer":"/paths/~1groups~1{groupID}~1divisions~1{divisionID}~1enrollment-summary/get/parameters"},{"nodeType":"item-content","variant":"headers","label":"Headers","labelTranslationKey":"header","parameters":[{"name":"vbasoftware-database","in":"header","schemaId":"schema_0","description":"Target database","required":true}],"pointer":"/paths/~1groups~1{groupID}~1divisions~1{divisionID}~1enrollment-summary/get/parameters"}],"panels":[{"children":[{"kind":"code-sample","source":{"kind":"code-sample","operationType":"http","method":"GET","path":"/groups/{groupID}/divisions/{divisionID}/enrollment-summary","servers":[{"url":"https://vbapi.vbasoftware.com/vbasoftware","description":"VBAPI production"}],"parameters":{"path":[{"name":"groupID","in":"path","required":true,"schemaId":"schema_0"},{"name":"divisionID","in":"path","required":true,"schemaId":"schema_0"}],"query":[],"querystring":[],"header":[{"name":"vbasoftware-database","in":"header","required":true,"schemaId":"schema_0"}],"cookie":[]},"security":[{"schemes":[{"id":"apiKeyAuth","type":"apiKey","name":"x-api-key","in":"header"},{"id":"bearerAuth","type":"http","scheme":"bearer","bearerFormat":"JWT"}],"scopes":[]}],"responseCodes":["200","401","403","429"],"pointer":"/groups/{groupID}/divisions/{divisionID}/enrollment-summary","href":"adv.-group-divisions/getgroupdivisionenrollmentsummary","openApiOperationId":"GetGroupDivisionEnrollmentSummary","summary":"Get Group enrollment summary information"},"isWebhook":false,"hideReplay":false,"servers":[{"url":"https://vbapi.vbasoftware.com/vbasoftware","description":"VBAPI production"}],"examples":[]}]}]},{"nodeType":"container","children":[{"nodeType":"header","level":4,"label":"Responses","labelTranslationKey":"responses","deepLinkSuffix":"responses"},{"nodeType":"item-content","variant":"responses","responses":[{"code":"200","description":"Success","mediaType":"application/json","mediaTypes":["application/json"],"mediaTypeContent":{"application/json":{"schemaId":"components/schemas/VBA_GroupContractEnrollmentSummaryListVBAResponse"}},"schemaId":"components/schemas/VBA_GroupContractEnrollmentSummaryListVBAResponse"},{"code":"401","description":"Unauthorized"},{"code":"403","description":"Forbidden. 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See VBAProcess area for more information."},{"nodeType":"security","requirements":[{"schemes":[{"name":"apiKeyAuth","scopes":[],"type":"apiKey","in":"header","paramName":"x-api-key","description":"Input apikey to access this API"},{"name":"bearerAuth","scopes":[],"type":"http","scheme":"bearer","bearerFormat":"JWT","description":"Input bearer token to access this API"}]}]},{"nodeType":"item-content","variant":"path","label":"Path","labelTranslationKey":"path","parameters":[{"name":"subscriberID","in":"path","schemaId":"schema_0","description":"Subscriber ID","required":true},{"name":"memberSeq","in":"path","schemaId":"schema_0","description":"Member Seq","required":true}],"pointer":"/paths/~1subscribers~1{subscriberID}~1members~1{memberSeq}~1reenroll/post/parameters"},{"nodeType":"item-content","variant":"headers","label":"Headers","labelTranslationKey":"header","parameters":[{"name":"vbasoftware-database","in":"header","schemaId":"schema_0","description":"Target database","required":true}],"pointer":"/paths/~1subscribers~1{subscriberID}~1members~1{memberSeq}~1reenroll/post/parameters"},{"nodeType":"item-content","variant":"body","label":"Request Body","labelTranslationKey":"body","required":true,"mediaTypes":["application/json"],"mediaTypeSchemas":{"application/json":{"schemaId":"components/schemas/EnrollmentReenroll"}},"schemaId":"components/schemas/EnrollmentReenroll","pointer":"/paths/~1subscribers~1{subscriberID}~1members~1{memberSeq}~1reenroll/post/requestBody"}],"panels":[{"children":[{"kind":"code-sample","source":{"kind":"code-sample","operationType":"http","method":"POST","path":"/subscribers/{subscriberID}/members/{memberSeq}/reenroll","servers":[{"url":"https://vbapi.vbasoftware.com/vbasoftware","description":"VBAPI production"}],"parameters":{"path":[{"name":"subscriberID","in":"path","required":true,"schemaId":"schema_0"},{"name":"memberSeq","in":"path","required":true,"schemaId":"schema_0"}],"query":[],"querystring":[],"header":[{"name":"vbasoftware-database","in":"header","required":true,"schemaId":"schema_0"}],"cookie":[]},"security":[{"schemes":[{"id":"apiKeyAuth","type":"apiKey","name":"x-api-key","in":"header"},{"id":"bearerAuth","type":"http","scheme":"bearer","bearerFormat":"JWT"}],"scopes":[]}],"requestBody":{"application/json":{"schemaId":"components/schemas/EnrollmentReenroll"}},"responseCodes":["200","401","403","429"],"pointer":"/subscribers/{subscriberID}/members/{memberSeq}/reenroll","href":"subscribers/memberreenroll","openApiOperationId":"MemberReenroll","summary":"Member Re-enroll"},"isWebhook":false,"hideReplay":false,"servers":[{"url":"https://vbapi.vbasoftware.com/vbasoftware","description":"VBAPI production"}],"schemaId":"components/schemas/EnrollmentReenroll","mediaTypes":["application/json"],"mediaTypeSchemas":{"application/json":{"schemaId":"components/schemas/EnrollmentReenroll"}},"examples":[]}]}]},{"nodeType":"container","children":[{"nodeType":"header","level":4,"label":"Responses","labelTranslationKey":"responses","deepLinkSuffix":"responses"},{"nodeType":"item-content","variant":"responses","responses":[{"code":"200","description":"Success","mediaType":"application/json","mediaTypes":["application/json"],"mediaTypeContent":{"application/json":{"schemaId":"components/schemas/VBAProcessVBAResponse"}},"schemaId":"components/schemas/VBAProcessVBAResponse"},{"code":"401","description":"Unauthorized"},{"code":"403","description":"Forbidden. 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Uses the VbapiClient helper described in /developer-portal/concepts/requests-and-responses.\nif find_enrollment():\n    print(\"Already enrolled in\", GROUP_ID, DIVISION_ID, coverage_start)\nelse:\n    response = api.post(f\"/subscribers/{SUBSCRIBER_ID}/add-enrollment\", {\n        \"requesting_User_ID\": REQUESTING_USER_ID,\n        \"addMembers\": True,\n        \"subEnrollment\": {\n            \"subscriber_ID\": SUBSCRIBER_ID,\n            \"group_ID\": GROUP_ID,\n            \"division_ID\": DIVISION_ID,\n            \"group_Coverage_Start\": f\"{coverage_start}T00:00:00\",\n            \"start_Date\": f\"{coverage_start}T00:00:00\",\n            \"end_Date\": f\"{coverage_end}T00:00:00\",\n        },\n    })\n    print(\"add-enrollment returned\", response.status)  # 202 Accepted, no body\n"},{"lang":"Node.js","label":"TypeScript","source":"// From the Enroll employees and dependents playbook. 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Wait and retry with exponential backoff and jitter."}],"pointer":"/paths/~1groups~1{groupID}~1volumes-batch/put/responses"}],"panels":[{"children":[{"kind":"response","responseCodes":[{"code":"207","schemaId":"components/schemas/MultiCodeResponseListVBAResponse","mediaTypes":["application/json"],"mediaTypeContent":{"application/json":{"schemaId":"components/schemas/MultiCodeResponseListVBAResponse"}}},{"code":"401"},{"code":"403"},{"code":"429"}],"examples":[]}]}]}]},"httpPath":"/groups/{groupID}/volumes-batch"}],"content":{"contentType":"group","meta":{"name":"Group Volumes"},"children":[{"nodeType":"container","children":[{"nodeType":"header","level":2,"label":"Group Volumes","showPageActions":true}],"panels":[{"children":[{"kind":"group-items","title":"Operations","titleTranslationKey":"operations","items":[{"title":"/groups/{groupID}/volumes","summary":"Create 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Uses the VbapiClient helper described in /developer-portal/concepts/requests-and-responses.\nif (await ExistsAsync(api, $\"/groups/{NewGroupId}\"))\n{\n    Console.WriteLine($\"Group {NewGroupId} already exists; skipping create\");\n}\nelse\n{\n    await api.PostAsync(\"/groups\", new\n    {\n        group_ID = NewGroupId,\n        name = \"Docs Sample Group\",\n        billing_Cycle_ID = billingCycleId,\n        // Required booleans. false is the safe default for a new group.\n        admin_COBRA = false,\n        advice_To_Pay = false,\n        apply_Ex_Code = false,\n        auth_Not_Reqd_Override = false,\n        coPay_Max_Per_Date_Provider = false,\n        default_Process_by_Disability_Date = false,\n        default_Roll_Up_Waiting_Period = false,\n        disable_COBRA_Auto_Select = false,\n        duplicate_Claim_Override = false,\n        individual_Billing = false,\n        individual_Cycle = false,\n        individual_Dates = false,\n        open_Closed_Enrollment = false,\n        paperless = false,\n        prepaid_Group = false,\n        prorate_Deduction = false,\n        self_Admin = false,\n        set_Billing_Due_Date = false,\n    });\n    Console.WriteLine($\"Created group {NewGroupId}\");\n}\n"},{"lang":"Python","label":"Python","source":"# From the Onboard a new employer group playbook. Uses the VbapiClient helper described in /developer-portal/concepts/requests-and-responses.\nif exists(api, f\"/groups/{NEW_GROUP_ID}\"):\n    print(\"Group\", NEW_GROUP_ID, \"already exists; skipping create\")\nelse:\n    api.post(\"/groups\", {\n        \"group_ID\": NEW_GROUP_ID,\n        \"name\": \"Docs Sample Group\",\n        \"billing_Cycle_ID\": billing_cycle_id,\n        # Required booleans. false is the safe default for a new group.\n        \"admin_COBRA\": False,\n        \"advice_To_Pay\": False,\n        \"apply_Ex_Code\": False,\n        \"auth_Not_Reqd_Override\": False,\n        \"coPay_Max_Per_Date_Provider\": False,\n        \"default_Process_by_Disability_Date\": False,\n        \"default_Roll_Up_Waiting_Period\": False,\n        \"disable_COBRA_Auto_Select\": False,\n        \"duplicate_Claim_Override\": False,\n        \"individual_Billing\": False,\n        \"individual_Cycle\": False,\n        \"individual_Dates\": False,\n        \"open_Closed_Enrollment\": False,\n        \"paperless\": False,\n        \"prepaid_Group\": False,\n        \"prorate_Deduction\": False,\n        \"self_Admin\": False,\n        \"set_Billing_Due_Date\": False,\n    })\n    print(\"Created group\", NEW_GROUP_ID)\n"},{"lang":"Node.js","label":"TypeScript","source":"// From the Onboard a new employer group playbook. Uses the VbapiClient helper described in /developer-portal/concepts/requests-and-responses.\nif (await exists(api, `/groups/${NEW_GROUP_ID}`)) {\n  console.log(`Group ${NEW_GROUP_ID} already exists; skipping create`);\n} else {\n  await api.post(\"/groups\", {\n    group_ID: NEW_GROUP_ID,\n    name: \"Docs Sample Group\",\n    billing_Cycle_ID: billingCycleId,\n    // Required booleans. false is the safe default for a new group.\n    admin_COBRA: false,\n    advice_To_Pay: false,\n    apply_Ex_Code: false,\n    auth_Not_Reqd_Override: false,\n    coPay_Max_Per_Date_Provider: false,\n    default_Process_by_Disability_Date: false,\n    default_Roll_Up_Waiting_Period: false,\n    disable_COBRA_Auto_Select: false,\n    duplicate_Claim_Override: false,\n    individual_Billing: false,\n    individual_Cycle: false,\n    individual_Dates: false,\n    open_Closed_Enrollment: false,\n    paperless: false,\n    prepaid_Group: false,\n    prorate_Deduction: false,\n    self_Admin: false,\n    set_Billing_Due_Date: false,\n  });\n  console.log(`Created group ${NEW_GROUP_ID}`);\n}\n"}],"isWebhook":false,"hideReplay":false,"servers":[{"url":"https://vbapi.vbasoftware.com/vbasoftware","description":"VBAPI production"}],"schemaId":"components/schemas/Groups","mediaTypes":["application/json"],"mediaTypeSchemas":{"application/json":{"schemaId":"components/schemas/Groups"}},"examples":[]}]}]},{"nodeType":"container","children":[{"nodeType":"header","level":4,"label":"Responses","labelTranslationKey":"responses","deepLinkSuffix":"responses"},{"nodeType":"item-content","variant":"responses","responses":[{"code":"200","description":"Success","mediaType":"application/json","mediaTypes":["application/json"],"mediaTypeContent":{"application/json":{"schemaId":"components/schemas/GroupsVBAResponse"}},"schemaId":"components/schemas/GroupsVBAResponse"},{"code":"401","description":"Unauthorized"},{"code":"403","description":"Forbidden. The x-api-key header is missing or not valid. The API gateway sends this response, not VBAPI, so the body is not the VBAPI envelope; see Errors and troubleshooting."},{"code":"429","description":"Too many requests. The limit is 25 requests per second sustained, with bursts up to 50, per API key. Wait and retry with exponential backoff and jitter."}],"pointer":"/paths/~1groups/post/responses"}],"panels":[{"children":[{"kind":"response","responseCodes":[{"code":"200","schemaId":"components/schemas/GroupsVBAResponse","mediaTypes":["application/json"],"mediaTypeContent":{"application/json":{"schemaId":"components/schemas/GroupsVBAResponse"}}},{"code":"401"},{"code":"403"},{"code":"429"}],"examples":[]}]}]}]},"httpPath":"/groups"},{"label":"List Groups","deprecated":false,"httpVerb":"get","isAdditionalOperation":false,"isWebhook":false,"type":"link","link":"/openapi/vbasoftware/vbasoftware.api/groups/listgroups","routeSlug":"/openapi/vbasoftware/vbasoftware.api/groups/listgroups","metadata":{"seo":{"title":"List Groups","description":"Lists all Groups"}},"content":{"contentType":"item","itemVariant":"httpItem","meta":{"sourceId":"ListGroups","name":"List Groups","isWebhook":false,"pointer":"/paths/~1groups/get","hasSamples":true},"children":[{"nodeType":"container","children":[{"nodeType":"header","level":2,"label":"List Groups","isWebhook":false,"showPageActions":true}],"panels":[]},{"nodeType":"container","children":[{"nodeType":"header","level":4,"label":"Request","labelTranslationKey":"request","deepLinkSuffix":"request"},{"nodeType":"markdoc","content":"Lists all Groups"},{"nodeType":"security","requirements":[{"schemes":[{"name":"apiKeyAuth","scopes":[],"type":"apiKey","in":"header","paramName":"x-api-key","description":"Input apikey to access this API"},{"name":"bearerAuth","scopes":[],"type":"http","scheme":"bearer","bearerFormat":"JWT","description":"Input bearer token to access this API"}]}]},{"nodeType":"item-content","variant":"query","label":"Query","labelTranslationKey":"query","parameters":[{"name":"page","in":"query","schemaId":"schema_4","description":"Page number. Pages start at 1; page 0 returns 500."},{"name":"pageSize","in":"query","schemaId":"schema_5","description":"Items per page. Defaults to 100. The server sets no maximum; choose a size your client can process in one response."},{"name":"sortBy","in":"query","schemaId":"schema_0","description":"Comma separated string to sort by. Each sort field can be followed by :asc or :desc to specify sort direction, ascending is default. E.g., 'Property1:desc,Property2:asc,Property3:asc' sorts Property1 in descending order, Property2 in ascending, and Property3 in ascending."}],"pointer":"/paths/~1groups/get/parameters"},{"nodeType":"item-content","variant":"headers","label":"Headers","labelTranslationKey":"header","parameters":[{"name":"vbasoftware-database","in":"header","schemaId":"schema_0","description":"Target database","required":true}],"pointer":"/paths/~1groups/get/parameters"}],"panels":[{"children":[{"kind":"code-sample","source":{"kind":"code-sample","operationType":"http","method":"GET","path":"/groups","servers":[{"url":"https://vbapi.vbasoftware.com/vbasoftware","description":"VBAPI production"}],"parameters":{"path":[],"query":[{"name":"page","in":"query","schemaId":"schema_4"},{"name":"pageSize","in":"query","schemaId":"schema_5"},{"name":"sortBy","in":"query","schemaId":"schema_0"}],"querystring":[],"header":[{"name":"vbasoftware-database","in":"header","required":true,"schemaId":"schema_0"}],"cookie":[]},"security":[{"schemes":[{"id":"apiKeyAuth","type":"apiKey","name":"x-api-key","in":"header"},{"id":"bearerAuth","type":"http","scheme":"bearer","bearerFormat":"JWT"}],"scopes":[]}],"responseCodes":["200","401","403","429"],"pointer":"/groups","href":"groups/listgroups","openApiOperationId":"ListGroups","summary":"List Groups"},"definitionSamples":[{"lang":"C#","label":"C#","source":"// From the quick start (the Quick start). Runs on its own.\nusing var request = new HttpRequestMessage(HttpMethod.Get, $\"{baseUrl}/groups?page=1&pageSize=5\");\nrequest.Headers.Authorization = new AuthenticationHeaderValue(\"Bearer\", idToken);\n\nusing var response = await http.SendAsync(request);\nresponse.EnsureSuccessStatusCode();\nif (response.Headers.TryGetValues(\"X-Pagination\", out var paging))\n{\n    Console.WriteLine($\"Paging: {string.Join(\"\", paging)}\");\n}\nusing var body = JsonDocument.Parse(await response.Content.ReadAsStringAsync());\nforeach (var group in body.RootElement.GetProperty(\"data\").EnumerateArray())\n{\n    Console.WriteLine($\"{group.GetProperty(\"group_ID\").GetString()} - {group.GetProperty(\"name\").GetString()}\");\n}\n"},{"lang":"Python","label":"Python","source":"# From the quick start (the Quick start). Runs on its own.\ndef list_groups(id_token: str) -> None:\n    response = requests.get(\n        f\"{BASE_URL}/groups\",\n        params={\"page\": 1, \"pageSize\": 5},\n        headers={\n            \"x-api-key\": API_KEY,\n            \"Authorization\": f\"Bearer {id_token}\",\n            \"vbasoftware-database\": DATABASE,\n            \"User-Agent\": USER_AGENT,\n        },\n        timeout=30,\n    )\n    response.raise_for_status()\n    body = response.json()\n    print(\"Paging:\", response.headers.get(\"X-Pagination\"))\n    for group in body[\"data\"]:\n        print(group[\"group_ID\"], \"-\", group[\"name\"])\n"},{"lang":"Node.js","label":"TypeScript","source":"// From the quick start (the Quick start). Runs on its own.\nasync function listGroups(idToken: string): Promise<void> {\n  const response = await axios.get(`${BASE_URL}/groups`, {\n    params: { page: 1, pageSize: 5 },\n    headers: {\n      \"x-api-key\": API_KEY,\n      Authorization: `Bearer ${idToken}`,\n      \"vbasoftware-database\": DATABASE,\n      \"User-Agent\": USER_AGENT,\n    },\n  });\n  console.log(\"Paging:\", response.headers[\"x-pagination\"]);\n  for (const group of response.data.data) {\n    console.log(`${group.group_ID} - ${group.name}`);\n  }\n}\n"}],"isWebhook":false,"hideReplay":false,"servers":[{"url":"https://vbapi.vbasoftware.com/vbasoftware","description":"VBAPI production"}],"examples":[]}]}]},{"nodeType":"container","children":[{"nodeType":"header","level":4,"label":"Responses","labelTranslationKey":"responses","deepLinkSuffix":"responses"},{"nodeType":"item-content","variant":"responses","responses":[{"code":"200","description":"Success","mediaType":"application/json","mediaTypes":["application/json"],"mediaTypeContent":{"application/json":{"schemaId":"components/schemas/GroupsListVBAResponse"}},"schemaId":"components/schemas/GroupsListVBAResponse","headers":{"X-Pagination":{"$ref":"#/components/headers/VbapiPagination"}},"headerSchemaId":"schema_6"},{"code":"401","description":"Unauthorized"},{"code":"403","description":"Forbidden. The x-api-key header is missing or not valid. The API gateway sends this response, not VBAPI, so the body is not the VBAPI envelope; see Errors and troubleshooting."},{"code":"429","description":"Too many requests. The limit is 25 requests per second sustained, with bursts up to 50, per API key. Wait and retry with exponential backoff and jitter."}],"pointer":"/paths/~1groups/get/responses"}],"panels":[{"children":[{"kind":"response","responseCodes":[{"code":"200","schemaId":"components/schemas/GroupsListVBAResponse","mediaTypes":["application/json"],"mediaTypeContent":{"application/json":{"schemaId":"components/schemas/GroupsListVBAResponse"}}},{"code":"401"},{"code":"403"},{"code":"429"}],"examples":[]}]}]}]},"httpPath":"/groups"},{"label":"Get Groups","deprecated":false,"httpVerb":"get","isAdditionalOperation":false,"isWebhook":false,"type":"link","link":"/openapi/vbasoftware/vbasoftware.api/groups/getgroups","routeSlug":"/openapi/vbasoftware/vbasoftware.api/groups/getgroups","metadata":{"seo":{"title":"Get Groups","description":"Gets Groups"}},"content":{"contentType":"item","itemVariant":"httpItem","meta":{"sourceId":"GetGroups","name":"Get Groups","isWebhook":false,"pointer":"/paths/~1groups~1{groupID}/get","hasSamples":false},"children":[{"nodeType":"container","children":[{"nodeType":"header","level":2,"label":"Get Groups","isWebhook":false,"showPageActions":true}],"panels":[]},{"nodeType":"container","children":[{"nodeType":"header","level":4,"label":"Request","labelTranslationKey":"request","deepLinkSuffix":"request"},{"nodeType":"markdoc","content":"Gets Groups"},{"nodeType":"security","requirements":[{"schemes":[{"name":"apiKeyAuth","scopes":[],"type":"apiKey","in":"header","paramName":"x-api-key","description":"Input apikey to access this API"},{"name":"bearerAuth","scopes":[],"type":"http","scheme":"bearer","bearerFormat":"JWT","description":"Input bearer token to access this API"}]}]},{"nodeType":"item-content","variant":"path","label":"Path","labelTranslationKey":"path","parameters":[{"name":"groupID","in":"path","schemaId":"schema_0","description":"Group ID","required":true}],"pointer":"/paths/~1groups~1{groupID}/get/parameters"},{"nodeType":"item-content","variant":"headers","label":"Headers","labelTranslationKey":"header","parameters":[{"name":"vbasoftware-database","in":"header","schemaId":"schema_0","description":"Target database","required":true}],"pointer":"/paths/~1groups~1{groupID}/get/parameters"}],"panels":[{"children":[{"kind":"code-sample","source":{"kind":"code-sample","operationType":"http","method":"GET","path":"/groups/{groupID}","servers":[{"url":"https://vbapi.vbasoftware.com/vbasoftware","description":"VBAPI production"}],"parameters":{"path":[{"name":"groupID","in":"path","required":true,"schemaId":"schema_0"}],"query":[],"querystring":[],"header":[{"name":"vbasoftware-database","in":"header","required":true,"schemaId":"schema_0"}],"cookie":[]},"security":[{"schemes":[{"id":"apiKeyAuth","type":"apiKey","name":"x-api-key","in":"header"},{"id":"bearerAuth","type":"http","scheme":"bearer","bearerFormat":"JWT"}],"scopes":[]}],"responseCodes":["200","401","403","429"],"pointer":"/groups/{groupID}","href":"groups/getgroups","openApiOperationId":"GetGroups","summary":"Get Groups"},"isWebhook":false,"hideReplay":false,"servers":[{"url":"https://vbapi.vbasoftware.com/vbasoftware","description":"VBAPI production"}],"examples":[]}]}]},{"nodeType":"container","children":[{"nodeType":"header","level":4,"label":"Responses","labelTranslationKey":"responses","deepLinkSuffix":"responses"},{"nodeType":"item-content","variant":"responses","responses":[{"code":"200","description":"Success","mediaType":"application/json","mediaTypes":["application/json"],"mediaTypeContent":{"application/json":{"schemaId":"components/schemas/GroupsVBAResponse"}},"schemaId":"components/schemas/GroupsVBAResponse"},{"code":"401","description":"Unauthorized"},{"code":"403","description":"Forbidden. 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This is now done through the Auth Adjustment process where a new Auth is created referencing the original Auth.","format":"double","nullable":true},"amount_Actual":{"type":"number","description":"Total approved amount that has been used.","format":"double","nullable":true},"amount_Approved":{"type":"number","description":"Approved amount of the authorization.","format":"double","nullable":true},"amount_Denied":{"type":"number","description":"Denied amount of the authorization.","format":"double","nullable":true},"amount_Requested":{"type":"number","description":"Requested amount of the authorization.","format":"double","nullable":true},"approved_By":{"maxLength":50,"type":"string","description":"User that either approved, pended, or denied the authorization.","nullable":true},"approved_Date":{"type":"string","description":"Date when the authorization was approved, denied, or pended as specified by the status field.","format":"date-time","nullable":true},"approved_Frequency":{"maxLength":16,"type":"string","description":"Authorization frequency that is/was approved.","nullable":true},"approved_From":{"type":"string","description":"Date when the authorization approval starts/started.","format":"date-time","nullable":true},"approved_Location":{"maxLength":4,"type":"string","description":"Approved location of the authorization.","nullable":true},"approved_Thru":{"type":"string","description":"Date when the authorization approval expires/expired.","format":"date-time","nullable":true},"assigned_User":{"maxLength":20,"type":"string","description":"User that the authorization was assigned to.","nullable":true},"audit_Flag":{"maxLength":1,"type":"string","description":"Information field used in custom reporting.","nullable":true},"auth_Code":{"maxLength":8,"type":"string","description":"Code that indicates the authorization status.","nullable":true},"auth_Type":{"maxLength":8,"type":"string","description":"Indicates the type of authorization. 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This is repalced by the Status field.  Note: The database will apply a default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"False"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" for this field if a value is not provided.  This field is also marked as NOT NULL in the database and therefore required by the API.  If you do not have a value for this field, supply the database default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"False"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" to meet the API requirements and ensure that the functionality occurs as expected."},"children":[]}]}]}]},"drG_Category":{"maxLength":8,"type":"string","description":"Identifies the category of the selected DRG Code.","nullable":true},"drG_Code":{"maxLength":8,"type":"string","description":"Specifies a DRG code that is to be associated with the authorization.","nullable":true},"daily_Living":{"type":"integer","description":"Identifies that the authoization is associated with a claim that is affecting the patient's daily living.","format":"int32","nullable":true},"denied_From":{"type":"string","description":"Date when the authorization denial starts/started.","format":"date-time","nullable":true},"denied_Thru":{"type":"string","description":"Date when the authorization denial expires/expired.","format":"date-time","nullable":true},"discharge_Date":{"type":"string","description":"Date when the patient was discharged.","format":"date-time","nullable":true},"entry_Date":{"type":"string","description":"Date when the record was first added to the system.","format":"date-time"},"entry_User":{"maxLength":20,"type":"string","description":"User that first added the record to the system.","nullable":true},"federal_ID":{"maxLength":20,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"VBA internal Federal_ID of the Provider associated with the Auth. 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For Notes/Comments/Narrative information you would use the Note Services area.","nullable":true},"new_Or_Extended":{"type":"boolean","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Indicates that the associated authorization is a new authorization or an extension of the original authorization.  Note: The database will apply a default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"False"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" for this field if a value is not provided.  This field is also marked as NOT NULL in the database and therefore required by the API.  If you do not have a value for this field, supply the database default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"False"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" to meet the API requirements and ensure that the functionality occurs as expected."},"children":[]}]}]}]},"notes":{"type":"string","description":"Field that allows the User to add any additional information to the authorization.","nullable":true},"ordered_By_ID":{"maxLength":20,"type":"string","description":"ID of the Provider who ordered this auth.","nullable":true},"ordered_By_Name":{"maxLength":512,"type":"string","description":"Name of the Provider who ordered this auth.","nullable":true},"other_Coverage_Primary":{"maxLength":1,"type":"string","description":"Information field used in custom reporting.","nullable":true},"other_Insurance":{"maxLength":2,"type":"string","description":"Check this box to indicate that the associated Member has other insurance.","nullable":true},"payee_ID":{"maxLength":20,"type":"string","description":"ID of the Payee associated with the auth.","nullable":true},"plan_ID":{"maxLength":20,"type":"string","description":"Unique identifier assigned to the plan.","nullable":true},"previous_Auth":{"maxLength":20,"type":"string","description":"This field is no longer used as it has been replaced by the the Auth Adjustment process where an AuthReference record is created instead.","nullable":true},"previous_Treatment":{"type":"boolean","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Check this box to indicate that previous treatment had been administered.  Note: The database will apply a default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"False"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" for this field if a value is not provided.  This field is also marked as NOT NULL in the database and therefore required by the API.  If you do not have a value for this field, supply the database default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"False"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" to meet the API requirements and ensure that the functionality occurs as expected."},"children":[]}]}]}]},"prior_Auth":{"maxLength":20,"type":"string","description":"References Prior Auth","nullable":true},"provider_ID":{"maxLength":20,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"VBA internal Provider_ID of the Provider associated with the Auth. 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If you do not have a value for this field, supply the database default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"False"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" to meet the API requirements and ensure that the functionality occurs as expected."},"children":[]}]}]}]},"tPlan_DownLoaded_Date":{"type":"string","description":"Indicates the date the Treatment Plan was downloaded from the application.","format":"date-time","nullable":true},"tPlan_DownLoaded_User":{"maxLength":20,"type":"string","description":"Indicates the user what downloaded the Treatment Plan from the application.","nullable":true},"tPlan_Printed":{"maxLength":1,"minLength":1,"type":"string","description":"Flag indicating if this Auth has been printed as a Treatment Plan."},"tPlan_Printed_Date":{"type":"string","description":"The date this Auth has been printed as a Treatment Plan.","format":"date-time","nullable":true},"total_Actual":{"type":"number","description":"No longer in use.","format":"double","nullable":true},"total_Approved":{"type":"number","description":"No longer in use.","format":"double","nullable":true},"total_Requested":{"type":"number","description":"No longer in use.","format":"double","nullable":true},"total_Unit_Type":{"maxLength":16,"type":"string","description":"No longer in use.","nullable":true},"treatment_Type":{"maxLength":8,"type":"string","description":"Indicates the type of treatment that is being authorized.","nullable":true},"type_Of_Service":{"maxLength":5,"type":"string","description":"No longer in use.","nullable":true},"unit_Type":{"maxLength":16,"type":"string","description":"Unit type that is used for the associated service. 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Note: The database will apply a default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"False"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" for this field if a value is not provided.  This field is also marked as NOT NULL in the database and therefore required by the API.  If you do not have a value for this field, supply the database default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"False"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" to meet the API requirements and ensure that the functionality occurs as expected."},"children":[]}]}]}]},"visits_Actual":{"type":"number","description":"Number of visits used as part of the authorization.","format":"double","nullable":true},"visits_Approved":{"type":"number","description":"Number of visits approved as part of the authorization.","format":"double","nullable":true},"visits_Requested":{"type":"number","description":"Number of visits requested as part of the authorization.","format":"double","nullable":true},"visits_To_Date":{"type":"number","description":"Number of visits that have been used up to the current date.","format":"double","nullable":true},"work_Related":{"maxLength":1,"type":"string","description":"Check this box to indicate that the authorization is related to work.","nullable":true}},"additionalProperties":false,"description":"Authorization request/response DTO for Auth API create, update, and batch operations."}},"components/schemas/AuthAction":{"id":"components/schemas/AuthAction","kind":"json-schema","title":"AuthAction","data":{"required":["auth_Action"],"type":"object","properties":{"auth_Action":{"maxLength":1,"minLength":1,"type":"string","description":"Specifies what action will be applied by the associated status code: Approved - full authorization amount will be approved. Denied - full authorization amount will be denied. Pended - requested authorization amount has been pended for review. Voided - authorization has been removed. 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This field is also marked as NOT NULL in the database and therefore required by the API.  If you do not have a value for this field, supply the database default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"False"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" to meet the API requirements and ensure that the functionality occurs as expected."},"children":[]}]}]}]},"ceridian_Exported":{"type":"boolean","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Used in custom integration with ceridian tax services.  Note: The database will apply a default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"False"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" for this field if a value is not provided.  This field is also marked as NOT NULL in the database and therefore required by the API.  If you do not have a value for this field, supply the database default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"False"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" to meet the API requirements and ensure that the functionality occurs as expected."},"children":[]}]}]}]},"ceridian_Exported_Date":{"type":"string","description":"Used in custom integration with ceridian tax services.","format":"date-time","nullable":true},"check_Batch":{"type":"integer","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"This is the primary indicator if a claim is \"Paid\". When this value is NULL, the claim has been processed but not paid. When paid, this value will hold what Check Batch the claim was paid under. References CheckBatch.Check_Batch."},"children":[]}]}]}],"format":"int32","nullable":true},"check_ID":{"type":"integer","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Holds the Check ID this claim was paid under. References Checks.Check_ID."},"children":[]}]}]}],"format":"int32","nullable":true},"check_Number":{"maxLength":20,"type":"string","description":"No longer in use.","nullable":true},"claim_837_COB":{"maxLength":1,"type":"string","description":"For 837 transactions, indicates COB has been submitted.","nullable":true},"claim_Exported":{"type":"boolean","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Used by VBA Backroom IT Services to track export status of a claim. This has since been moved to ClaimExport tables and is no longer in use.  Note: The database will apply a default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"False"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" for this field if a value is not provided.  This field is also marked as NOT NULL in the database and therefore required by the API.  If you do not have a value for this field, supply the database default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"False"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" to meet the API requirements and ensure that the functionality occurs as expected."},"children":[]}]}]}]},"claim_Exported_Date":{"type":"string","description":"Used by VBA Backroom IT Services to track export status of a claim. This has since been moved to ClaimExport tables and is no longer in use.","format":"date-time","nullable":true},"claim_Funded_Status":{"maxLength":32,"type":"string","description":"Indicates the Claim Funded Status for this claim, indicating if the claim is ready for funding, suspended, a candidate for payment, part of a funding request or funded.","nullable":true},"claim_ID":{"maxLength":32,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"An identifier assigned by external vendors and used for integrations. Primarily comes from the REF*D9 value in the 837."},"children":[]}]}]}],"nullable":true},"claim_Priority":{"maxLength":1,"type":"string","description":"For 837 transactions, indicates the submitted claim priority.","nullable":true},"claim_Status":{"maxLength":8,"type":"string","description":"The status of the claim. Valid values reside in the ClaimStatus table.","nullable":true},"claim_Type":{"maxLength":20,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Notes the claim type for this claim. References ClaimType.Claim_Type."},"children":[]}]}]}],"nullable":true},"closure_Effective_Date":{"type":"string","description":"This is an information only field that allows the tracking of the Closure Effective Date.","format":"date-time","nullable":true},"condition_Code1":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code10":{"maxLength":8,"type":"string","nullable":true},"condition_Code11":{"maxLength":8,"type":"string","nullable":true},"condition_Code12":{"maxLength":8,"type":"string","nullable":true},"condition_Code13":{"maxLength":8,"type":"string","nullable":true},"condition_Code14":{"maxLength":8,"type":"string","nullable":true},"condition_Code15":{"maxLength":8,"type":"string","nullable":true},"condition_Code16":{"maxLength":8,"type":"string","nullable":true},"condition_Code17":{"maxLength":8,"type":"string","nullable":true},"condition_Code18":{"maxLength":8,"type":"string","nullable":true},"condition_Code19":{"maxLength":8,"type":"string","nullable":true},"condition_Code2":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code20":{"maxLength":8,"type":"string","nullable":true},"condition_Code21":{"maxLength":8,"type":"string","nullable":true},"condition_Code22":{"maxLength":8,"type":"string","nullable":true},"condition_Code23":{"maxLength":8,"type":"string","nullable":true},"condition_Code24":{"maxLength":8,"type":"string","nullable":true},"condition_Code3":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code4":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code5":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code6":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code7":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code8":{"maxLength":8,"type":"string","nullable":true},"condition_Code9":{"maxLength":8,"type":"string","nullable":true},"coverage_Start":{"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"The patients (or Subscribers) enrollment information, references Subenrollment.Group_Coverage_Start."},"children":[]}]}]}],"format":"date-time","nullable":true},"current_Illness_Date":{"type":"string","description":"The current illness date for this claim.","format":"date-time","nullable":true},"drG_Code":{"maxLength":4,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"The DRG Code for this claim, if applicable. References the DRGCodes.DRG_Code."},"children":[]}]}]}],"nullable":true},"drG_Quantity":{"type":"number","description":"The quantity associated with this DRG value.","format":"double","nullable":true},"death_Cert_Rec_Date":{"type":"string","description":"Information field used in custom processing and reporting.","format":"date-time","nullable":true},"delivery_Date":{"type":"string","description":"This identifies the date of delivery for disability due to pregnancy.","format":"date-time","nullable":true},"delivery_Type":{"maxLength":1,"type":"string","description":"This will identify the type of delivery that is performed as a result of pregnancy.","nullable":true},"dep_SSDI_End_Date":{"type":"string","description":"This is an information only field that allows the tracking of Dependent SSI End Date.","format":"date-time","nullable":true},"diagnostic_Code1":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim. This field, in the absence of a corresponding diagnosis pointer from a claim service line, indicates the primary diagnosis.","nullable":true},"diagnostic_Code10":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code11":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code12":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code13":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code14":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code15":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code16":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code17":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code18":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code19":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code2":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code20":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code21":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code22":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code23":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code24":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code3":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code4":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code5":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code6":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code7":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code8":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code9":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code_Type":{"maxLength":16,"minLength":1,"type":"string","description":"Indicates if the Diagnostic Code values on this claim are ICD9 or ICD10. Two possible values: 9 - ICD9 or 0 - ICD10."},"disability_Date":{"type":"string","description":"The calculated date of disability (or manually enetered) based on the disabilty advisor in VBASoftware.","format":"date-time","nullable":true},"disability_End_Date":{"type":"string","description":"Information field used in custom processing and reporting.","format":"date-time","nullable":true},"disability_Type":{"maxLength":20,"type":"string","description":"Used to identify the type of disability (Injury or Illness).","nullable":true},"disabled_By_Physician":{"type":"string","description":"This identifies the date the member was disabled by the Physician. This field, in combination with First Attended Physician Date and Last Day Worked, create the Disability Date for the Member.","format":"date-time","nullable":true},"discharge_Date":{"type":"string","description":"Used to identify the date the member was discharged from the Hospital if hospitalized as part of this disability.","format":"date-time","nullable":true},"discharge_Hour":{"maxLength":8,"type":"string","description":"For institutional Claims, holds the Discharge Hour.","nullable":true},"division_ID":{"maxLength":20,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"The patients (or Subscribers) enrollment information, references Subenrollment.Division_ID."},"children":[]}]}]}],"nullable":true},"eCode_Diagnostic_Code":{"maxLength":8,"type":"string","description":"The external cause of injury code for this claim, if applicable.","nullable":true},"eCode_Diagnostic_Code10":{"maxLength":8,"type":"string","description":"The external cause of injury code for this claim, if applicable.","nullable":true},"eCode_Diagnostic_Code11":{"maxLength":8,"type":"string","description":"The external cause of injury code for this claim, if applicable.","nullable":true},"eCode_Diagnostic_Code12":{"maxLength":8,"type":"string","description":"The external cause of injury code for this claim, if applicable.","nullable":true},"eCode_Diagnostic_Code2":{"maxLength":8,"type":"string","description":"The external cause of injury code for this claim, if applicable.","nullable":true},"eCode_Diagnostic_Code3":{"maxLength":8,"type":"string","description":"The external cause of injury code for this claim, if applicable.","nullable":true},"eCode_Diagnostic_Code4":{"maxLength":8,"type":"string","description":"The external cause of injury code for this claim, if applicable.","nullable":true},"eCode_Diagnostic_Code5":{"maxLength":8,"type":"string","description":"The external cause of injury code for this claim, if applicable.","nullable":true},"eCode_Diagnostic_Code6":{"maxLength":8,"type":"string","description":"The external cause of injury code for this claim, if applicable.","nullable":true},"eCode_Diagnostic_Code7":{"maxLength":8,"type":"string","description":"The external cause of injury code for this claim, if applicable.","nullable":true},"eCode_Diagnostic_Code8":{"maxLength":8,"type":"string","description":"The external cause of injury code for this claim, if applicable.","nullable":true},"eCode_Diagnostic_Code9":{"maxLength":8,"type":"string","description":"The external cause of injury code for this claim, if applicable.","nullable":true},"epsdT_Condition_Indicator1":{"maxLength":3,"type":"string","description":"Early and Periodic Screening, Diagnostic, and Treatment Indicator tracked from the claim submission.","nullable":true},"epsdT_Condition_Indicator2":{"maxLength":3,"type":"string","description":"Early and Periodic Screening, Diagnostic, and Treatment Indicator tracked from the claim submission.","nullable":true},"epsdT_Condition_Indicator3":{"maxLength":3,"type":"string","description":"Early and Periodic Screening, Diagnostic, and Treatment Indicator tracked from the claim submission.","nullable":true},"epsdT_Referral_Given":{"maxLength":1,"type":"string","description":"Early and Periodic Screening, Diagnostic, and Treatment tracking for if a referral was given for this claim.","nullable":true},"entry_Date":{"type":"string","description":"Date when the record was first added to the system.","format":"date-time"},"entry_User":{"maxLength":20,"type":"string","description":"User that first added the record to the system.","nullable":true},"ex_Code1":{"maxLength":6,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code."},"children":[]}]}]}],"nullable":true},"ex_Code2":{"maxLength":6,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code."},"children":[]}]}]}],"nullable":true},"ex_Code3":{"maxLength":8,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code."},"children":[]}]}]}],"nullable":true},"ex_Code4":{"maxLength":8,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code."},"children":[]}]}]}],"nullable":true},"exhaust_Date":{"type":"string","description":"This is the Exhaust Date of the members Disability.","format":"date-time","nullable":true},"expected_Typical_Duration":{"type":"integer","description":"Expected Typical Duration (ETD) is the duration of disability identified by the MDA based on the type of job the member has as well as the diagnosis of the disability.","format":"int32","nullable":true},"ficA_Percent":{"type":"number","description":"This will hold the FICA withhold amount for each payment. If tax calculation module is enabled, this option will be ignored.","format":"double","nullable":true},"federal_Withheld":{"type":"number","description":"This will hold the federal withhold amount for each payment. 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Indicated in Box 22 of the claim report.","nullable":true},"group_ID":{"maxLength":20,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"The patients (or Subscribers) enrollment information, references Subenrollment.Group_ID."},"children":[]}]}]}],"nullable":true},"hearing_Vision_RX_Date":{"type":"string","description":"Information field used in custom processing and reporting.","format":"date-time","nullable":true},"image_File_Location":{"maxLength":128,"type":"string","description":"Stores a reference, if applicable, to an image or document associated with this claim.","nullable":true},"image_File_Location2":{"maxLength":128,"type":"string","description":"Stores a reference, if applicable, to an image or document associated with this claim.","nullable":true},"image_File_Location3":{"maxLength":128,"type":"string","description":"Stores a reference, if applicable, to an image or document associated with this claim.","nullable":true},"image_File_Location4":{"maxLength":128,"type":"string","description":"Stores a reference, if applicable, to an image or document associated with this claim.","nullable":true},"initial_Treatment_Date":{"type":"string","description":"Information field to track the initial treatment date for this claim.","format":"date-time","nullable":true},"job_Type":{"maxLength":2,"type":"string","description":"This is the job classification for the member going on disability.","nullable":true},"ltD_Effective_Date":{"type":"string","description":"This is an information only field that holds the date the member went on Long-Term Disability.","format":"date-time","nullable":true},"ltD_Packet_Date":{"type":"string","description":"This is an information only field that tracks the date the Long-Term Disability Packet was sent.","format":"date-time","nullable":true},"last_Day_Worked":{"type":"string","description":"This identifies the date the member last attended work prior to going on disability. 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Note: The database will apply a default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"False"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" for this field if a value is not provided.  This field is also marked as NOT NULL in the database and therefore required by the API.  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This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"attend_Provider_Last_Name":{"maxLength":35,"type":"string","description":"The attending provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"attend_Provider_MAID":{"maxLength":20,"type":"string","description":"The attending provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"attend_Provider_NPI":{"maxLength":20,"type":"string","description":"The attending provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"attend_Provider_Org_Name":{"maxLength":512,"type":"string","description":"The attending provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"attend_Provider_Phone":{"maxLength":20,"type":"string","description":"The attending provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"attend_Provider_State":{"maxLength":10,"type":"string","description":"The attending provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"attend_Provider_Taxonomy":{"maxLength":10,"type":"string","description":"The attending provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"attend_Provider_Zip":{"maxLength":32,"type":"string","description":"The attending provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"attended_Physician_Date":{"type":"string","description":"This identifies the date the member first visited the Physician. This field, in combination with Disabled by Physician Date and Last Day Worked, create the Disability Date for the Member.","format":"date-time","nullable":true},"auto_Flex":{"type":"boolean","description":"For flex claims, notes that this claim was auto-created by adjudication based on configuration at the group. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"baseloadLookup":{"type":"boolean","description":"Flagged when a claim has gone through the baseload provider matching service. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"beneficiary_ID":{"maxLength":20,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Notes the beneficiary for Life & Disability claims. References the MemberBeneficiary.Beneficiary_ID."},"children":[]}]}]}],"nullable":true},"bill_Provider_Address":{"maxLength":90,"type":"string","description":"The billing provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"bill_Provider_Address2":{"maxLength":90,"type":"string","description":"The billing provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"bill_Provider_City":{"maxLength":30,"type":"string","description":"The billing provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"bill_Provider_Federal_ID":{"maxLength":20,"type":"string","description":"The billing provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"bill_Provider_First_Name":{"maxLength":25,"type":"string","description":"The billing provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"bill_Provider_Last_Name":{"maxLength":35,"type":"string","description":"The billing provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"bill_Provider_MAID":{"maxLength":20,"type":"string","description":"The billing provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"bill_Provider_NPI":{"maxLength":20,"type":"string","description":"The billing provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"bill_Provider_Org_Name":{"maxLength":512,"type":"string","description":"The billing provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"bill_Provider_Phone":{"maxLength":20,"type":"string","description":"The billing provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"bill_Provider_State":{"maxLength":10,"type":"string","description":"The billing provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"bill_Provider_Taxonomy":{"maxLength":10,"type":"string","description":"The billing provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"bill_Provider_Zip":{"maxLength":32,"type":"string","description":"The billing provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"billed_Amount":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Holds the claim level billed amount that is used for balancing the claim detail billed_price values. If different, throws an error."},"children":[]}]}]}],"format":"double","nullable":true},"cliA_Number":{"maxLength":32,"type":"string","description":"No longer in use.","nullable":true},"calculate_Interest":{"type":"boolean","description":"Notes if interest was calculated for this claim as part of adjudication. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"capitation_Claim":{"type":"boolean","description":"Indicates if this claim is capitated. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"claim_837_COB":{"maxLength":1,"type":"string","description":"For 837 transactions, indicates COB has been submitted.","nullable":true},"claim_ID":{"maxLength":32,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"An identifier assigned by external vendors and used for integrations. Primarily comes from the REF*D9 value in the 837."},"children":[]}]}]}],"nullable":true},"claim_Priority":{"maxLength":1,"type":"string","description":"For 837 transactions, indicates the submitted claim priority.","nullable":true},"claim_Status":{"maxLength":8,"type":"string","description":"The status of the claim. Valid values reside in the ClaimStatus table.","nullable":true},"claim_Type":{"maxLength":20,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Notes the claim type for this claim. References ClaimType.Claim_Type."},"children":[]}]}]}],"nullable":true},"closure_Effective_Date":{"type":"string","description":"This is an information only field that allows the tracking of the Closure Effective Date.","format":"date-time","nullable":true},"condition_Code1":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code10":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code11":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code12":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code13":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code14":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code15":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code16":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code17":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code18":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code19":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code2":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code20":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code21":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code22":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code23":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code24":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code3":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code4":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code5":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code6":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code7":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code8":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"condition_Code9":{"maxLength":8,"type":"string","description":"The Condition Code value for this claim.","nullable":true},"context4_Override":{"type":"boolean","description":"Allows the user to flag a claim to ignore Context4Health service results and stick to core adjudication edits. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"coverage_Start":{"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"The patients (or Subscribers) enrollment information, references Subenrollment.Group_Coverage_Start."},"children":[]}]}]}],"format":"date-time","nullable":true},"current_Illness_Date":{"type":"string","description":"The current illness date for this claim.","format":"date-time","nullable":true},"drG_Code":{"maxLength":4,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"The DRG Code for this claim, if applicable. References the DRGCodes.DRG_Code."},"children":[]}]}]}],"nullable":true},"drG_Quantity":{"type":"number","description":"The quantity associated with this DRG value.","format":"double","nullable":true},"death_Cert_Rec_Date":{"type":"string","description":"Information field used in custom processing and reporting.","format":"date-time","nullable":true},"delivery_Date":{"type":"string","description":"This identifies the date of delivery for disability due to pregnancy.","format":"date-time","nullable":true},"delivery_Type":{"maxLength":1,"type":"string","description":"This will identify the type of delivery that is performed as a result of pregnancy.","nullable":true},"dep_SSDI_End_Date":{"type":"string","description":"This is an information only field that allows the tracking of Dependent SSI End Date.","format":"date-time","nullable":true},"diagnostic_Code1":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim. This field, in the absence of a corresponding diagnosis pointer from a claim service line, indicates the primary diagnosis.","nullable":true},"diagnostic_Code10":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code11":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code12":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code13":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code14":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code15":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code16":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code17":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code18":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code19":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code2":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code20":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code21":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code22":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code23":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code24":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code3":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code4":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code5":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code6":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code7":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code8":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code9":{"maxLength":8,"type":"string","description":"An assigned diagnostic code for this claim.","nullable":true},"diagnostic_Code_Type":{"maxLength":16,"minLength":1,"type":"string","description":"Indicates if the Diagnostic Code values on this claim are ICD9 or ICD10. Two possible values: 9 - ICD9 or 0 - ICD10. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"disability_Date":{"type":"string","description":"The calculated date of disability (or manually enetered) based on the disabilty advisor in VBASoftware.","format":"date-time","nullable":true},"disability_End_Date":{"type":"string","description":"Information field used in custom processing and reporting.","format":"date-time","nullable":true},"disability_Type":{"maxLength":20,"type":"string","description":"Used to identify the type of disability (Injury or Illness).","nullable":true},"disabled_By_Physician":{"type":"string","description":"This identifies the date the member was disabled by the Physician. This field, in combination with First Attended Physician Date and Last Day Worked, create the Disability Date for the Member.","format":"date-time","nullable":true},"discharge_Date":{"type":"string","description":"Used to identify the date the member was discharged from the Hospital if hospitalized as part of this disability.","format":"date-time","nullable":true},"discharge_Hour":{"maxLength":8,"type":"string","description":"For institutional Claims, holds the Discharge Hour.","nullable":true},"division_ID":{"maxLength":20,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"The patients (or Subscribers) enrollment information, references Subenrollment.Division_ID."},"children":[]}]}]}],"nullable":true},"eCode_Diagnostic_Code":{"maxLength":8,"type":"string","description":"The external cause of injury code for this claim, if applicable.","nullable":true},"eCode_Diagnostic_Code10":{"maxLength":8,"type":"string","description":"The external cause of injury code for this claim, if applicable.","nullable":true},"eCode_Diagnostic_Code11":{"maxLength":8,"type":"string","description":"The external cause of injury code for this claim, if applicable.","nullable":true},"eCode_Diagnostic_Code12":{"maxLength":8,"type":"string","description":"The external cause of injury code for this claim, if applicable.","nullable":true},"eCode_Diagnostic_Code2":{"maxLength":8,"type":"string","description":"The external cause of injury code for this claim, if applicable.","nullable":true},"eCode_Diagnostic_Code3":{"maxLength":8,"type":"string","description":"The external cause of injury code for this claim, if applicable.","nullable":true},"eCode_Diagnostic_Code4":{"maxLength":8,"type":"string","description":"The external cause of injury code for this claim, if applicable.","nullable":true},"eCode_Diagnostic_Code5":{"maxLength":8,"type":"string","description":"The external cause of injury code for this claim, if applicable.","nullable":true},"eCode_Diagnostic_Code6":{"maxLength":8,"type":"string","description":"The external cause of injury code for this claim, if applicable.","nullable":true},"eCode_Diagnostic_Code7":{"maxLength":8,"type":"string","description":"The external cause of injury code for this claim, if applicable.","nullable":true},"eCode_Diagnostic_Code8":{"maxLength":8,"type":"string","description":"The external cause of injury code for this claim, if applicable.","nullable":true},"eCode_Diagnostic_Code9":{"maxLength":8,"type":"string","description":"The external cause of injury code for this claim, if applicable.","nullable":true},"epsdT_Condition_Indicator1":{"maxLength":3,"type":"string","description":"Early and Periodic Screening, Diagnostic, and Treatment Indicator tracked from the claim submission.","nullable":true},"epsdT_Condition_Indicator2":{"maxLength":3,"type":"string","description":"Early and Periodic Screening, Diagnostic, and Treatment Indicator tracked from the claim submission.","nullable":true},"epsdT_Condition_Indicator3":{"maxLength":3,"type":"string","description":"Early and Periodic Screening, Diagnostic, and Treatment Indicator tracked from the claim submission.","nullable":true},"epsdT_Referral_Given":{"maxLength":1,"type":"string","description":"Early and Periodic Screening, Diagnostic, and Treatment tracking for if a referral was given for this claim.","nullable":true},"entry_Date":{"type":"string","description":"Date when the record was first added to the system.","format":"date-time"},"entry_User":{"maxLength":20,"type":"string","description":"User that first added the record to the system.","nullable":true},"error_Amount":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Auth":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Beneficiary":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Benefit":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_ConditionCode":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Dates":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Detail":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Diag1":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Diag10":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Diag11":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Diag12":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Diag13":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Diag14":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Diag15":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Diag16":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Diag17":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Diag18":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Diag19":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Diag2":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Diag20":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Diag21":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Diag22":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Diag23":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Diag24":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Diag3":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Diag4":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Diag5":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Diag6":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Diag7":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Diag8":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Diag9":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_ExCode1":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_ExCode2":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Exists":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Group":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Mem":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Network":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_OccurrenceCode":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Plan":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Procedure":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Prov":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Sub":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_ValueCode":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"ex_Code1":{"maxLength":6,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code."},"children":[]}]}]}],"nullable":true},"ex_Code2":{"maxLength":6,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code."},"children":[]}]}]}],"nullable":true},"ex_Code3":{"maxLength":8,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code."},"children":[]}]}]}],"nullable":true},"ex_Code4":{"maxLength":8,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code."},"children":[]}]}]}],"nullable":true},"exhaust_Date":{"type":"string","description":"This is the Exhaust Date of the members Disability.","format":"date-time","nullable":true},"expected_Typical_Duration":{"type":"integer","description":"Expected Typical Duration (ETD) is the duration of disability identified by the MDA based on the type of job the member has as well as the diagnosis of the disability.","format":"int32","nullable":true},"ficA_Percent":{"type":"number","description":"This will hold the FICA withhold amount for each payment. If tax calculation module is enabled, this option will be ignored.","format":"double","nullable":true},"federal_Withheld":{"type":"number","description":"This will hold the federal withhold amount for each payment. If tax calculation module is enabled, this option will be ignored.","format":"double","nullable":true},"filing_Indicator":{"maxLength":2,"type":"string","description":"No longer in use.","nullable":true},"followUp_Date":{"type":"string","description":"This will place a follow-up date on each payment as an additional identifier for when this disability should be reviewed.","format":"date-time","nullable":true},"followUp_Ex_Code":{"maxLength":6,"type":"string","description":"This will place a follow-up ex code on each payment to allow the user to categorize what type of follow-up is being performed.","nullable":true},"freq_Code":{"maxLength":8,"type":"string","description":"Medicare Resubmission code for the claim. Indicated in Box 22 of the claim report.","nullable":true},"group_ID":{"maxLength":20,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"The patients (or Subscribers) enrollment information, references Subenrollment.Group_ID."},"children":[]}]}]}],"nullable":true},"hearing_Vision_RX_Date":{"type":"string","description":"Information field used in custom processing and reporting.","format":"date-time","nullable":true},"image_File_Location":{"maxLength":128,"type":"string","description":"Stores a reference, if applicable, to an image or document associated with this claim.","nullable":true},"image_File_Location2":{"maxLength":128,"type":"string","description":"Stores a reference, if applicable, to an image or document associated with this claim.","nullable":true},"image_File_Location3":{"maxLength":128,"type":"string","description":"Stores a reference, if applicable, to an image or document associated with this claim.","nullable":true},"image_File_Location4":{"maxLength":128,"type":"string","description":"Stores a reference, if applicable, to an image or document associated with this claim.","nullable":true},"initial_Treatment_Date":{"type":"string","description":"Information field to track the initial treatment date for this claim.","format":"date-time","nullable":true},"insured_Address":{"maxLength":128,"type":"string","description":"For EDI submissions, this holds the Insured information so it can be tracked via trigger to the ClaimPreBatch table.","nullable":true},"insured_Address2":{"maxLength":128,"type":"string","description":"For EDI submissions, this holds the Insured information so it can be tracked via trigger to the ClaimPreBatch table.","nullable":true},"insured_Alternate_ID":{"maxLength":32,"type":"string","description":"For EDI submissions, this holds the Insured information so it can be tracked via trigger to the ClaimPreBatch table.","nullable":true},"insured_Birth_Date":{"type":"string","description":"For EDI submissions, this holds the Insured information so it can be tracked via trigger to the ClaimPreBatch table.","format":"date-time","nullable":true},"insured_City":{"maxLength":32,"type":"string","description":"For EDI submissions, this holds the Insured information so it can be tracked via trigger to the ClaimPreBatch table.","nullable":true},"insured_Employer_ID":{"maxLength":32,"type":"string","description":"For EDI submissions, this holds the Insured information so it can be tracked via trigger to the ClaimPreBatch table.","nullable":true},"insured_First_Name":{"maxLength":32,"type":"string","description":"For EDI submissions, this holds the Insured information so it can be tracked via trigger to the ClaimPreBatch table.","nullable":true},"insured_ID":{"maxLength":32,"type":"string","description":"For EDI submissions, this holds the Insured information so it can be tracked via trigger to the ClaimPreBatch table.","nullable":true},"insured_Last_Name":{"maxLength":32,"type":"string","description":"For EDI submissions, this holds the Insured information so it can be tracked via trigger to the ClaimPreBatch table.","nullable":true},"insured_Phone":{"maxLength":32,"type":"string","description":"For EDI submissions, this holds the Insured information so it can be tracked via trigger to the ClaimPreBatch table.","nullable":true},"insured_Policy_Number":{"maxLength":64,"type":"string","description":"For EDI submissions, this holds the Insured information so it can be tracked via trigger to the ClaimPreBatch table.","nullable":true},"insured_SSN":{"maxLength":32,"type":"string","description":"For EDI submissions, this holds the Insured information so it can be tracked via trigger to the ClaimPreBatch table.","nullable":true},"insured_Sex":{"maxLength":1,"type":"string","description":"For EDI submissions, this holds the Insured information so it can be tracked via trigger to the ClaimPreBatch table.","nullable":true},"insured_State":{"maxLength":64,"type":"string","description":"For EDI submissions, this holds the Insured information so it can be tracked via trigger to the ClaimPreBatch table.","nullable":true},"insured_Zip":{"maxLength":32,"type":"string","description":"For EDI submissions, this holds the Insured information so it can be tracked via trigger to the ClaimPreBatch table.","nullable":true},"job_Type":{"maxLength":2,"type":"string","description":"This is the job classification for the member going on disability.","nullable":true},"ltD_Effective_Date":{"type":"string","description":"This is an information only field that holds the date the member went on Long-Term 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Note: This field is marked as NOT NULL in the database and therefore required by the API."},"mail_To":{"maxLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Notes if the payment should be mailed to an entity other than the \"Send_Check_To\"."},"children":[]}]}]}],"nullable":true},"member_Seq":{"maxLength":2,"type":"string","description":"The Member Sequence of the patient for this claim.","nullable":true},"months_Of_Treatment":{"type":"integer","description":"The number of months the orthodontic treatment will be.","format":"int32","nullable":true},"network_ID":{"maxLength":10,"type":"string","description":"Indicates the network this claim was paid against. If this value is NULL, the claim is considered \"Out of Network\".","nullable":true},"note":{"maxLength":24,"type":"string","description":"No longer in use.","nullable":true},"occupational":{"type":"boolean","description":"Notes if the disability is related to the patiens occupation. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"occurrence_Code1":{"maxLength":8,"type":"string","description":"The Occurrence Code value for this claim.","nullable":true},"occurrence_Code10":{"maxLength":8,"type":"string","description":"The Occurrence Code value for this claim.","nullable":true},"occurrence_Code11":{"maxLength":8,"type":"string","description":"The Occurrence Code value for this claim.","nullable":true},"occurrence_Code12":{"maxLength":8,"type":"string","description":"The Occurrence Code value for this claim.","nullable":true},"occurrence_Code13":{"maxLength":8,"type":"string","description":"The Occurrence Code value for this claim.","nullable":true},"occurrence_Code14":{"maxLength":8,"type":"string","description":"The Occurrence Code value for this claim.","nullable":true},"occurrence_Code15":{"maxLength":8,"type":"string","description":"The Occurrence Code value for this 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claim.","format":"date-time","nullable":true},"occurrence_Span_Thru4":{"type":"string","description":"The occurrence span from for this claim.","format":"date-time","nullable":true},"occurrence_Span_Thru5":{"type":"string","description":"The occurrence span from for this claim.","format":"date-time","nullable":true},"occurrence_Span_Thru6":{"type":"string","description":"The occurrence span from for this claim.","format":"date-time","nullable":true},"occurrence_Span_Thru7":{"type":"string","description":"The occurrence span from for this claim.","format":"date-time","nullable":true},"occurrence_Span_Thru8":{"type":"string","description":"The occurrence span from for this claim.","format":"date-time","nullable":true},"occurrence_Span_Thru9":{"type":"string","description":"The occurrence span from for this claim.","format":"date-time","nullable":true},"onset_Similar_Illness_Date":{"type":"string","description":"Notes the date of the original illness if this claim is associated to that illness.","format":"date-time","nullable":true},"oper_Provider_Address":{"maxLength":90,"type":"string","description":"The operating physician information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"oper_Provider_Address2":{"maxLength":90,"type":"string","description":"The operating physician information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"oper_Provider_City":{"maxLength":30,"type":"string","description":"The operating physician information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"oper_Provider_Federal_ID":{"maxLength":20,"type":"string","description":"The operating physician information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"oper_Provider_First_Name":{"maxLength":25,"type":"string","description":"The operating physician information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"oper_Provider_Last_Name":{"maxLength":35,"type":"string","description":"The operating physician information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"oper_Provider_MAID":{"maxLength":20,"type":"string","description":"The operating physician information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"oper_Provider_NPI":{"maxLength":20,"type":"string","description":"The operating physician information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"oper_Provider_Org_Name":{"maxLength":512,"type":"string","description":"The operating physician information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"oper_Provider_Phone":{"maxLength":20,"type":"string","description":"The operating physician information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"oper_Provider_State":{"maxLength":10,"type":"string","description":"The operating physician information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"oper_Provider_Taxonomy":{"maxLength":10,"type":"string","description":"The operating physician information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"oper_Provider_Zip":{"maxLength":32,"type":"string","description":"The operating physician information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"orthodontics_Treatment":{"type":"boolean","description":"When this flag is checked, it indicates the dental claim is for orthodontics. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"other_Insurance":{"type":"boolean","description":"Indicates if other insurance is applicable on this claim. This indicator unlocks COB amount fields on the ClaimDetail (service line). Note: This field is marked as NOT NULL in the database and therefore required by the API."},"other_Procedure_Code1":{"maxLength":8,"type":"string","description":"Additional procedure code (ICD10 Diagnosis) values for this claim submission.","nullable":true},"other_Procedure_Code10":{"maxLength":8,"type":"string","description":"Additional procedure code (ICD10 Diagnosis) values for this claim submission.","nullable":true},"other_Procedure_Code11":{"maxLength":8,"type":"string","description":"Additional procedure code (ICD10 Diagnosis) values for this claim submission.","nullable":true},"other_Procedure_Code12":{"maxLength":8,"type":"string","description":"Additional procedure code (ICD10 Diagnosis) values for this claim submission.","nullable":true},"other_Procedure_Code13":{"maxLength":8,"type":"string","description":"Additional procedure code (ICD10 Diagnosis) values for this claim submission.","nullable":true},"other_Procedure_Code14":{"maxLength":8,"type":"string","description":"Additional procedure code (ICD10 Diagnosis) values for this claim submission.","nullable":true},"other_Procedure_Code15":{"maxLength":8,"type":"string","description":"Additional procedure code (ICD10 Diagnosis) values for this claim submission.","nullable":true},"other_Procedure_Code16":{"maxLength":8,"type":"string","description":"Additional procedure code (ICD10 Diagnosis) values for this claim submission.","nullable":true},"other_Procedure_Code17":{"maxLength":8,"type":"string","description":"Additional procedure code (ICD10 Diagnosis) values for this claim submission.","nullable":true},"other_Procedure_Code18":{"maxLength":8,"type":"string","description":"Additional procedure code (ICD10 Diagnosis) values for this claim submission.","nullable":true},"other_Procedure_Code19":{"maxLength":8,"type":"string","description":"Additional procedure code (ICD10 Diagnosis) values for this claim submission.","nullable":true},"other_Procedure_Code2":{"maxLength":8,"type":"string","description":"Additional procedure code (ICD10 Diagnosis) values for this claim submission.","nullable":true},"other_Procedure_Code20":{"maxLength":8,"type":"string","description":"Additional procedure code (ICD10 Diagnosis) values for this claim submission.","nullable":true},"other_Procedure_Code21":{"maxLength":8,"type":"string","description":"Additional procedure code (ICD10 Diagnosis) values for this claim submission.","nullable":true},"other_Procedure_Code22":{"maxLength":8,"type":"string","description":"Additional procedure code (ICD10 Diagnosis) values for this claim submission.","nullable":true},"other_Procedure_Code23":{"maxLength":8,"type":"string","description":"Additional procedure code (ICD10 Diagnosis) values for this claim submission.","nullable":true},"other_Procedure_Code3":{"maxLength":8,"type":"string","description":"Additional procedure code (ICD10 Diagnosis) values for this claim submission.","nullable":true},"other_Procedure_Code4":{"maxLength":8,"type":"string","description":"Additional procedure code (ICD10 Diagnosis) values for this claim submission.","nullable":true},"other_Procedure_Code5":{"maxLength":8,"type":"string","description":"Additional procedure code (ICD10 Diagnosis) values for this claim submission.","nullable":true},"other_Procedure_Code6":{"maxLength":8,"type":"string","description":"Additional procedure code (ICD10 Diagnosis) values for this claim submission.","nullable":true},"other_Procedure_Code7":{"maxLength":8,"type":"string","description":"Additional procedure code (ICD10 Diagnosis) values for this claim submission.","nullable":true},"other_Procedure_Code8":{"maxLength":8,"type":"string","description":"Additional procedure code (ICD10 Diagnosis) values for this claim submission.","nullable":true},"other_Procedure_Code9":{"maxLength":8,"type":"string","description":"Additional procedure code (ICD10 Diagnosis) values for this claim submission.","nullable":true},"other_Procedure_Date1":{"type":"string","description":"Date associated with the additional procedure code.","format":"date-time","nullable":true},"other_Procedure_Date10":{"type":"string","description":"Date associated with the additional procedure code.","format":"date-time","nullable":true},"other_Procedure_Date11":{"type":"string","description":"Date associated with the additional procedure code.","format":"date-time","nullable":true},"other_Procedure_Date12":{"type":"string","description":"Date associated with the additional procedure code.","format":"date-time","nullable":true},"other_Procedure_Date13":{"type":"string","description":"Date associated with the additional procedure code.","format":"date-time","nullable":true},"other_Procedure_Date14":{"type":"string","description":"Date associated with the additional procedure code.","format":"date-time","nullable":true},"other_Procedure_Date15":{"type":"string","description":"Date associated with the additional procedure code.","format":"date-time","nullable":true},"other_Procedure_Date16":{"type":"string","description":"Date associated with the additional procedure code.","format":"date-time","nullable":true},"other_Procedure_Date17":{"type":"string","description":"Date associated with the additional procedure code.","format":"date-time","nullable":true},"other_Procedure_Date18":{"type":"string","description":"Date associated with the additional procedure code.","format":"date-time","nullable":true},"other_Procedure_Date19":{"type":"string","description":"Date associated with the additional procedure code.","format":"date-time","nullable":true},"other_Procedure_Date2":{"type":"string","description":"Date associated with the additional procedure code.","format":"date-time","nullable":true},"other_Procedure_Date20":{"type":"string","description":"Date associated with the additional procedure code.","format":"date-time","nullable":true},"other_Procedure_Date21":{"type":"string","description":"Date associated with the additional procedure code.","format":"date-time","nullable":true},"other_Procedure_Date22":{"type":"string","description":"Date associated with the additional procedure code.","format":"date-time","nullable":true},"other_Procedure_Date23":{"type":"string","description":"Date associated with the additional procedure code.","format":"date-time","nullable":true},"other_Procedure_Date3":{"type":"string","description":"Date associated with the additional procedure code.","format":"date-time","nullable":true},"other_Procedure_Date4":{"type":"string","description":"Date associated with the additional procedure code.","format":"date-time","nullable":true},"other_Procedure_Date5":{"type":"string","description":"Date associated with the additional procedure code.","format":"date-time","nullable":true},"other_Procedure_Date6":{"type":"string","description":"Date associated with the additional procedure code.","format":"date-time","nullable":true},"other_Procedure_Date7":{"type":"string","description":"Date associated with the additional procedure code.","format":"date-time","nullable":true},"other_Procedure_Date8":{"type":"string","description":"Date associated with the additional procedure code.","format":"date-time","nullable":true},"other_Procedure_Date9":{"type":"string","description":"Date associated with the additional procedure code.","format":"date-time","nullable":true},"override":{"maxLength":1,"type":"string","description":"No longer in use.","nullable":true},"override_Date":{"type":"string","description":"No longer in use.","format":"date-time","nullable":true},"override_Network_ID":{"type":"boolean","description":"This indicator lets the system know that the front end user has assigned this network ID and not adjudication. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_Payor_Account":{"type":"boolean","description":"Users can choose the payor from the More Information screen and this flag prevents adjudication from using the expected payor. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_User":{"maxLength":16,"type":"string","description":"No longer in use.","nullable":true},"partial_Disability":{"type":"boolean","description":"This will identify if this is a partial disability payment. Partial Disability payments have additional tax and payment rules applied during adjudication. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"patient_Account":{"maxLength":128,"type":"string","description":"For the servicing provider, this indicates the patient account identifier in their practice management system.","nullable":true},"patient_Address":{"maxLength":90,"type":"string","description":"For EDI submissions, this holds the Patient information so it can be tracked via trigger to the ClaimPreBatch table.","nullable":true},"patient_Address2":{"maxLength":90,"type":"string","description":"For EDI submissions, this holds the Patient information so it can be tracked via trigger to the ClaimPreBatch table.","nullable":true},"patient_Birth_Date":{"type":"string","description":"For EDI submissions, this holds the Patient information so it can be tracked via trigger to the ClaimPreBatch table.","format":"date-time","nullable":true},"patient_City":{"maxLength":30,"type":"string","description":"For EDI submissions, this holds the Patient information so it can be tracked via trigger to the ClaimPreBatch table.","nullable":true},"patient_First_Name":{"maxLength":25,"type":"string","description":"For EDI submissions, this holds the Patient information so it can be tracked via trigger to the ClaimPreBatch table.","nullable":true},"patient_ID":{"maxLength":32,"type":"string","description":"For EDI submissions, this holds the Insured information so it can be tracked via trigger to the ClaimPreBatch table.","nullable":true},"patient_Last_Name":{"maxLength":35,"type":"string","description":"For EDI submissions, this holds the Patient information so it can be tracked via trigger to the ClaimPreBatch table.","nullable":true},"patient_Phone":{"maxLength":20,"type":"string","description":"For EDI submissions, this holds the Patient information so it can be tracked via trigger to the ClaimPreBatch table.","nullable":true},"patient_Reason_for_Visit_Diagnostic_Code1":{"maxLength":8,"type":"string","description":"Reason for Visit code on Diagnosis Code 1","nullable":true},"patient_Reason_for_Visit_Diagnostic_Code2":{"maxLength":8,"type":"string","description":"Reason for Visit code on Diagnosis Code 2","nullable":true},"patient_Reason_for_Visit_Diagnostic_Code3":{"maxLength":8,"type":"string","description":"Reason for Visit code on Diagnosis Code 3","nullable":true},"patient_Relationship":{"maxLength":8,"type":"string","description":"For EDI submissions, this holds the Patient information so it can be tracked via trigger to the ClaimPreBatch table.","nullable":true},"patient_Sex":{"maxLength":1,"type":"string","description":"For EDI submissions, this holds the Patient information so it can be tracked via trigger to the ClaimPreBatch table.","nullable":true},"patient_Signature":{"type":"boolean","description":"Indicates if the patient signature has been collected. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"patient_Signature_Date":{"type":"string","description":"Indicates the date of the patient signature being collected.","format":"date-time","nullable":true},"patient_State":{"maxLength":50,"type":"string","description":"For EDI submissions, this holds the Patient information so it can be tracked via trigger to the ClaimPreBatch table.","nullable":true},"patient_Status":{"maxLength":8,"type":"string","description":"For institutional Claims, holds the Patient Status.","nullable":true},"patient_Zip":{"maxLength":32,"type":"string","description":"For EDI submissions, this holds the Patient information so it can be tracked via trigger to the ClaimPreBatch table.","nullable":true},"payToPlan_Address":{"maxLength":90,"type":"string","description":"The Pay To information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"payToPlan_Address2":{"maxLength":90,"type":"string","description":"The Pay To information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"payToPlan_City":{"maxLength":32,"type":"string","description":"The Pay To information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"payToPlan_Claim_Office_Num":{"maxLength":32,"type":"string","description":"The Pay To information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"payToPlan_ID":{"maxLength":32,"type":"string","description":"The Pay To information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"payToPlan_NAIC":{"maxLength":32,"type":"string","description":"The Pay To information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"payToPlan_Name":{"maxLength":512,"type":"string","description":"The Pay To information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"payToPlan_State":{"maxLength":10,"type":"string","description":"The Pay To information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"payToPlan_Zip":{"maxLength":32,"type":"string","description":"The Pay To information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"payTo_Address":{"maxLength":90,"type":"string","description":"The Pay To information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"payTo_Address2":{"maxLength":90,"type":"string","description":"The Pay To information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"payTo_City":{"maxLength":32,"type":"string","description":"The Pay To information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"payTo_State":{"maxLength":10,"type":"string","description":"The Pay To information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"payTo_Zip":{"maxLength":32,"type":"string","description":"The Pay To information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"payee_ID":{"maxLength":20,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"The billing provider (payee) for this claim. References the ProviderPayee.Payee_ID (by Provider_ID)."},"children":[]}]}]}],"nullable":true},"payor_Claim_Control_Number":{"maxLength":64,"type":"string","description":"A claim reference number used in conjunction with the Medicare Resubmission code. Indicated in Box 22 of the claim report.","nullable":true},"payor_ID":{"maxLength":20,"type":"string","description":"For claim funding, indicates the payor/account this claim would be paid from.","nullable":true},"physician_Return_To_Work":{"type":"string","description":"This is the Return to Work date identified by the Physician at the start of disability. This may or may not be the actual date the member returns to work.","format":"date-time","nullable":true},"place_Of_Service":{"maxLength":5,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Some transactions hold the Place of Service at the header but typically this value is empty and the ClaimDetail.Place_Of_Service is used for each service line. This value is not used in standard processing."},"children":[]}]}]}],"nullable":true},"plan_ID":{"maxLength":20,"type":"string","description":"Holds the plan the patient is enrolled in and that benefits are assigned.","nullable":true},"plan_Provider":{"maxLength":1,"type":"string","description":"No longer in use.","nullable":true},"plan_Year":{"maxLength":8,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Indicates the Plan Year this claim is processed under. This drives accumulator calculations and referneces the GroupPlanYear.Plan_Year value."},"children":[]}]}]}],"nullable":true},"present_On_Admission1":{"maxLength":1,"type":"string","description":"Indicates if the patient was present on admission for diagnosis 1.","nullable":true},"present_On_Admission10":{"maxLength":1,"type":"string","description":"Indicates if the patient was present on admission for diagnosis 10.","nullable":true},"present_On_Admission11":{"maxLength":1,"type":"string","description":"Indicates if the patient was present on admission for diagnosis 11.","nullable":true},"present_On_Admission12":{"maxLength":1,"type":"string","description":"Indicates if the patient was present on admission for diagnosis 12.","nullable":true},"present_On_Admission13":{"maxLength":1,"type":"string","description":"Indicates if the patient was present on admission for diagnosis 13.","nullable":true},"present_On_Admission14":{"maxLength":1,"type":"string","description":"Indicates if the patient was present on admission for diagnosis 14.","nullable":true},"present_On_Admission15":{"maxLength":1,"type":"string","description":"Indicates if the patient was present on admission for diagnosis 15.","nullable":true},"present_On_Admission16":{"maxLength":1,"type":"string","description":"Indicates if the patient was present on admission for diagnosis 16.","nullable":true},"present_On_Admission17":{"maxLength":1,"type":"string","description":"Indicates if the patient was present on admission for diagnosis 17.","nullable":true},"present_On_Admission18":{"maxLength":1,"type":"string","description":"Indicates if the patient was present on admission for diagnosis 18.","nullable":true},"present_On_Admission19":{"maxLength":1,"type":"string","description":"Indicates if the patient was present on admission for diagnosis 19.","nullable":true},"present_On_Admission2":{"maxLength":1,"type":"string","description":"Indicates if the patient was present on admission for diagnosis 2.","nullable":true},"present_On_Admission20":{"maxLength":1,"type":"string","description":"Indicates if the patient was present on admission for diagnosis 20.","nullable":true},"present_On_Admission21":{"maxLength":1,"type":"string","description":"Indicates if the patient was present on admission for diagnosis 21.","nullable":true},"present_On_Admission22":{"maxLength":1,"type":"string","description":"Indicates if the patient was present on admission for diagnosis 22.","nullable":true},"present_On_Admission23":{"maxLength":1,"type":"string","description":"Indicates if the patient was present on admission for diagnosis 23.","nullable":true},"present_On_Admission24":{"maxLength":1,"type":"string","description":"Indicates if the patient was present on admission for diagnosis 24.","nullable":true},"present_On_Admission3":{"maxLength":1,"type":"string","description":"Indicates if the patient was present on admission for diagnosis 3.","nullable":true},"present_On_Admission4":{"maxLength":1,"type":"string","description":"Indicates if the patient was present on admission for diagnosis 4.","nullable":true},"present_On_Admission5":{"maxLength":1,"type":"string","description":"Indicates if the patient was present on admission for diagnosis 5.","nullable":true},"present_On_Admission6":{"maxLength":1,"type":"string","description":"Indicates if the patient was present on admission for diagnosis 6.","nullable":true},"present_On_Admission7":{"maxLength":1,"type":"string","description":"Indicates if the patient was present on admission for diagnosis 7.","nullable":true},"present_On_Admission8":{"maxLength":1,"type":"string","description":"Indicates if the patient was present on admission for diagnosis 8.","nullable":true},"present_On_Admission9":{"maxLength":1,"type":"string","description":"Indicates if the patient was present on admission for diagnosis 9.","nullable":true},"present_On_Admission_ECode1":{"maxLength":1,"type":"string","description":"Indicates if the patient was present for the external cause of injury diagnosis 1.","nullable":true},"present_On_Admission_ECode10":{"maxLength":1,"type":"string","description":"Indicates if the patient was present for the external cause of injury diagnosis 10.","nullable":true},"present_On_Admission_ECode11":{"maxLength":1,"type":"string","description":"Indicates if the patient was present for the external cause of injury diagnosis 11.","nullable":true},"present_On_Admission_ECode12":{"maxLength":1,"type":"string","description":"Indicates if the patient was present for the external cause of injury diagnosis 12.","nullable":true},"present_On_Admission_ECode2":{"maxLength":1,"type":"string","description":"Indicates if the patient was present for the external cause of injury diagnosis 2.","nullable":true},"present_On_Admission_ECode3":{"maxLength":1,"type":"string","description":"Indicates if the patient was present for the external cause of injury diagnosis 3.","nullable":true},"present_On_Admission_ECode4":{"maxLength":1,"type":"string","description":"Indicates if the patient was present for the external cause of injury diagnosis 4.","nullable":true},"present_On_Admission_ECode5":{"maxLength":1,"type":"string","description":"Indicates if the patient was present for the external cause of injury diagnosis 5.","nullable":true},"present_On_Admission_ECode6":{"maxLength":1,"type":"string","description":"Indicates if the patient was present for the external cause of injury diagnosis 6.","nullable":true},"present_On_Admission_ECode7":{"maxLength":1,"type":"string","description":"Indicates if the patient was present for the external cause of injury diagnosis 7.","nullable":true},"present_On_Admission_ECode8":{"maxLength":1,"type":"string","description":"Indicates if the patient was present for the external cause of injury diagnosis 8.","nullable":true},"present_On_Admission_ECode9":{"maxLength":1,"type":"string","description":"Indicates if the patient was present for the external cause of injury diagnosis 9.","nullable":true},"pricing_Method":{"maxLength":8,"type":"string","description":"For reprice claims (typically submitted via 837), this notes the reprice method used to reprice this claim.","nullable":true},"pricing_Org_ID":{"maxLength":50,"type":"string","description":"The ID of the pricing organization. Data is obtained in segment HCP04 on an 837.","nullable":true},"pricing_Rate":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"The rate associated with the reprice method (Pricing_Method)."},"children":[]}]}]}],"format":"double","nullable":true},"principal_Procedure_Code":{"maxLength":8,"type":"string","description":"The principal procedure (ICD10 Diagnosis) for this claim submission.","nullable":true},"principal_Procedure_Date":{"type":"string","description":"The principal procedure date.","format":"date-time","nullable":true},"prior_Placement_Date":{"type":"string","description":"The date of a previous prosthetic or crown applied, if there was one.","format":"date-time","nullable":true},"prosthesis_Replacement":{"type":"boolean","description":"This flag indicates if this claim is for the replacement of a prosthesis. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"provider_Address":{"maxLength":90,"type":"string","description":"For EDI submissions, this holds the service provider information based on matching logic that interrogates the submitted Billing Provider, Service Provider, and Rendering Provider.","nullable":true},"provider_Address2":{"maxLength":90,"type":"string","description":"For EDI submissions, this holds the service provider information based on matching logic that interrogates the submitted Billing Provider, Service Provider, and Rendering Provider.","nullable":true},"provider_City":{"maxLength":30,"type":"string","description":"For EDI submissions, this holds the service provider information based on matching logic that interrogates the submitted Billing Provider, Service Provider, and Rendering Provider.","nullable":true},"provider_Federal_ID":{"maxLength":20,"type":"string","description":"For EDI submissions, this holds the service provider information based on matching logic that interrogates the submitted Billing Provider, Service Provider, and Rendering Provider.","nullable":true},"provider_First_Name":{"maxLength":30,"type":"string","description":"For EDI submissions, this holds the service provider information based on matching logic that interrogates the submitted Billing Provider, Service Provider, and Rendering Provider.","nullable":true},"provider_ID":{"maxLength":20,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"The provider ID of the servicing provider. References Provider.Provider_ID."},"children":[]}]}]}],"nullable":true},"provider_Last_Name":{"maxLength":30,"type":"string","description":"For EDI submissions, this holds the service provider information based on matching logic that interrogates the submitted Billing Provider, Service Provider, and Rendering Provider.","nullable":true},"provider_MAID":{"maxLength":20,"type":"string","description":"For EDI submissions, this holds the service provider information based on matching logic that interrogates the submitted Billing Provider, Service Provider, and Rendering Provider.","nullable":true},"provider_NPI":{"maxLength":20,"type":"string","description":"For EDI submissions, this holds the service provider information based on matching logic that interrogates the submitted Billing Provider, Service Provider, and Rendering Provider.","nullable":true},"provider_Org_Name":{"maxLength":512,"type":"string","description":"For EDI submissions, this holds the service provider information based on matching logic that interrogates the submitted Billing Provider, Service Provider, and Rendering Provider.","nullable":true},"provider_Phone":{"maxLength":20,"type":"string","description":"For EDI submissions, this holds the service provider information based on matching logic that interrogates the submitted Billing Provider, Service Provider, and Rendering Provider.","nullable":true},"provider_State":{"maxLength":10,"type":"string","description":"For EDI submissions, this holds the service provider information based on matching logic that interrogates the submitted Billing Provider, Service Provider, and Rendering Provider.","nullable":true},"provider_Taxonomy":{"maxLength":10,"type":"string","description":"For EDI submissions, this holds the service provider information based on matching logic that interrogates the submitted Billing Provider, Service Provider, and Rendering Provider.","nullable":true},"provider_Zip":{"maxLength":32,"type":"string","description":"For EDI submissions, this holds the service provider information based on matching logic that interrogates the submitted Billing Provider, Service Provider, and Rendering Provider.","nullable":true},"qpA_Method":{"maxLength":1,"type":"string","description":"Overrides the QPA Method set on the Plan for this claim.","nullable":true},"ready_To_Process":{"maxLength":1,"type":"string","description":"Notes if the claim is ready to process out of batch.","nullable":true},"received_Date":{"type":"string","description":"The date this claim was received into the admin system.","format":"date-time","nullable":true},"ref_Provider_Address":{"maxLength":90,"type":"string","description":"The referring provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"ref_Provider_Address2":{"maxLength":90,"type":"string","description":"The referring provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"ref_Provider_City":{"maxLength":30,"type":"string","description":"The referring provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"ref_Provider_Federal_ID":{"maxLength":20,"type":"string","description":"The referring provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"ref_Provider_First_Name":{"maxLength":25,"type":"string","description":"The referring provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"ref_Provider_Last_Name":{"maxLength":35,"type":"string","description":"The referring provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"ref_Provider_MAID":{"maxLength":20,"type":"string","description":"The referring provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"ref_Provider_NPI":{"maxLength":20,"type":"string","description":"The referring provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"ref_Provider_Org_Name":{"maxLength":512,"type":"string","description":"The referring provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"ref_Provider_Phone":{"maxLength":20,"type":"string","description":"The referring provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"ref_Provider_State":{"maxLength":10,"type":"string","description":"The referring provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"ref_Provider_Taxonomy":{"maxLength":10,"type":"string","description":"The referring provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"ref_Provider_Zip":{"maxLength":32,"type":"string","description":"The referring provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"referred_By":{"maxLength":30,"type":"string","description":"Information field to track if a referral was sent for this claim.","nullable":true},"refund_Check_ID":{"type":"integer","description":"Indicates that this claim was part of a Void process.","format":"int32","nullable":true},"refund_Claim":{"type":"boolean","description":"Indicates this claim is part of a refund process. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"refund_Funding_Key":{"type":"integer","description":"If this claim was part of a refund process, this will hold the reference to the receipt generated by the refund process.","format":"int32","nullable":true},"related_To_Accident":{"type":"boolean","description":"Indicates if the claim is related to a non-car accident. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"related_To_Another_Party":{"type":"boolean","description":"Indicates if the claim was casued by a third party. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"related_To_Auto":{"type":"boolean","description":"Indicates if the claim is related to a car accident. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"related_To_Employment":{"type":"boolean","description":"Indicates if the claim is work related. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"relinquished_Care_Date":{"type":"string","description":"Information field used in custom processing and reporting.","format":"date-time","nullable":true},"rend_Provider_Address":{"maxLength":90,"type":"string","description":"The rendering provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"rend_Provider_Address2":{"maxLength":90,"type":"string","description":"The rendering provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"rend_Provider_City":{"maxLength":30,"type":"string","description":"The rendering provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"rend_Provider_Federal_ID":{"maxLength":20,"type":"string","description":"The rendering provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"rend_Provider_First_Name":{"maxLength":25,"type":"string","description":"The rendering provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"rend_Provider_Last_Name":{"maxLength":35,"type":"string","description":"The rendering provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"rend_Provider_MAID":{"maxLength":20,"type":"string","description":"The rendering provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"rend_Provider_NPI":{"maxLength":20,"type":"string","description":"The rendering provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"rend_Provider_Org_Name":{"maxLength":512,"type":"string","description":"The rendering provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"rend_Provider_Phone":{"maxLength":20,"type":"string","description":"The rendering provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"rend_Provider_State":{"maxLength":10,"type":"string","description":"The rendering provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"rend_Provider_Taxonomy":{"maxLength":10,"type":"string","description":"The rendering provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"rend_Provider_Zip":{"maxLength":32,"type":"string","description":"The rendering provider information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"repriced_Network_ID":{"maxLength":10,"type":"string","description":"As part of reprice claim submissions (via 837), this will hold the repricing network.","nullable":true},"return_To_Work_Date":{"type":"string","description":"This is the date the member Returned to Work. This date affects the total payments created as well as other calculations during adjudication.","format":"date-time","nullable":true},"salary_Continuation":{"type":"boolean","description":"This flag identifies that there is salary continuation during this disability. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"send_Check_To":{"maxLength":1,"type":"string","description":"Indicates the entity that should be paid for this claim. S - Subscriber, G - Group, B - Beneficiary, P - Payee, or V - Provider.","nullable":true},"sender_ID":{"maxLength":15,"type":"string","description":"The Sender ID sent inbound for x12 (837) transactions.","nullable":true},"service_Date":{"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"The earliest Service_Date of all service lines on this claim."},"children":[]}]}]}],"format":"date-time","nullable":true},"service_Fac_Loc_Address":{"maxLength":90,"type":"string","description":"The service facility information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"service_Fac_Loc_Address2":{"maxLength":90,"type":"string","description":"The service facility information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"service_Fac_Loc_City":{"maxLength":30,"type":"string","description":"The service facility information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"service_Fac_Loc_Federal_ID":{"maxLength":20,"type":"string","description":"The service facility information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"service_Fac_Loc_First_Name":{"maxLength":25,"type":"string","description":"The service facility information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"service_Fac_Loc_Last_Name":{"maxLength":35,"type":"string","description":"The service facility information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"service_Fac_Loc_MAID":{"maxLength":20,"type":"string","description":"The service facility information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"service_Fac_Loc_NPI":{"maxLength":20,"type":"string","description":"The service facility information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"service_Fac_Loc_Org_Name":{"maxLength":512,"type":"string","description":"The service facility information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"service_Fac_Loc_Phone":{"maxLength":20,"type":"string","description":"The service facility information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"service_Fac_Loc_State":{"maxLength":10,"type":"string","description":"The service facility information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"service_Fac_Loc_Taxonomy":{"maxLength":10,"type":"string","description":"The service facility information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"service_Fac_Loc_Zip":{"maxLength":32,"type":"string","description":"The service facility information as submitted on the 837. This field is used for tracking via trigger to the ClaimPreBatch.","nullable":true},"service_Thru":{"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"The latest Service_Thru for all service lines on this claim."},"children":[]}]}]}],"format":"date-time","nullable":true},"sick_Time":{"type":"boolean","description":"This flag identifies that there is sick time during this disability. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"statement_From_Date":{"type":"string","description":"For Institutional Claims, holds the Statement Date.","format":"date-time","nullable":true},"statement_Thru_Date":{"type":"string","description":"For Institutional Claims, holds the Statement Date.","format":"date-time","nullable":true},"subscriber_ID":{"maxLength":9,"type":"string","description":"The Subscriber ID of the patient for this claim.","nullable":true},"subscriber_Signature":{"type":"boolean","description":"Indicates if the insured signature has been collected. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"survivor_Benefit":{"type":"boolean","description":"Indicates if Survivor Benefit was applied for this disability payment. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"third_Party_Payment":{"type":"boolean","description":"For disability, indicates if this professional claim is a 3rd party payment (typically related to alimony, garnishment, etc.) Note: This field is marked as NOT NULL in the database and therefore required by the API."},"total_COB":{"type":"number","description":"COB total for all claim detail lines Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"trading_Partner_Key":{"type":"integer","description":"No longer in use.","format":"int32","nullable":true},"trans_837_Control_Num":{"maxLength":9,"type":"string","description":"For 837 transactions, this is the control number assgined by the submitter.","nullable":true},"transaction_837":{"type":"boolean","description":"Indicates this is a claim entered by an inbound 837. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"transaction_837_ID":{"maxLength":30,"type":"string","description":"For 837 transactions, this holds the transaction ID assigned by the submission.","nullable":true},"type_Of_Admission":{"maxLength":6,"type":"string","description":"The Admission Type associated to this claim.","nullable":true},"type_Of_Bill":{"maxLength":6,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"The Bill Type associated to this claim. References BillType.Type_Of_Bill."},"children":[]}]}]}],"nullable":true},"update_Date":{"type":"string","description":"Date when the record was last updated in the system.","format":"date-time"},"update_User":{"maxLength":20,"type":"string","description":"User that last updated the record in the system.","nullable":true},"vacation":{"type":"boolean","description":"This flag identifies that there is vacation during this disability. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"value_Amount1":{"type":"number","description":"The monetary amount related to the value code.","format":"double","nullable":true},"value_Amount10":{"type":"number","description":"The monetary amount related to the value code.","format":"double","nullable":true},"value_Amount11":{"type":"number","description":"The monetary amount related to the value code.","format":"double","nullable":true},"value_Amount12":{"type":"number","description":"The monetary amount related to the value code.","format":"double","nullable":true},"value_Amount13":{"type":"number","description":"The monetary amount related to the value code.","format":"double","nullable":true},"value_Amount14":{"type":"number","description":"The monetary amount related to the value code.","format":"double","nullable":true},"value_Amount15":{"type":"number","description":"The monetary amount related to the value code.","format":"double","nullable":true},"value_Amount16":{"type":"number","description":"The monetary amount related to the value code.","format":"double","nullable":true},"value_Amount17":{"type":"number","description":"The monetary amount related to the value code.","format":"double","nullable":true},"value_Amount18":{"type":"number","description":"The monetary amount related to the value code.","format":"double","nullable":true},"value_Amount19":{"type":"number","description":"The monetary amount related to the value code.","format":"double","nullable":true},"value_Amount2":{"type":"number","description":"The monetary amount related to the value code.","format":"double","nullable":true},"value_Amount20":{"type":"number","description":"The monetary amount related to the value code.","format":"double","nullable":true},"value_Amount21":{"type":"number","description":"The monetary amount related to the value code.","format":"double","nullable":true},"value_Amount22":{"type":"number","description":"The monetary amount related to the value code.","format":"double","nullable":true},"value_Amount23":{"type":"number","description":"The monetary amount related to the value code.","format":"double","nullable":true},"value_Amount24":{"type":"number","description":"The monetary amount related to the value code.","format":"double","nullable":true},"value_Amount3":{"type":"number","description":"The monetary amount related to the value code.","format":"double","nullable":true},"value_Amount4":{"type":"number","description":"The monetary amount related to the value code.","format":"double","nullable":true},"value_Amount5":{"type":"number","description":"The monetary amount related to the value code.","format":"double","nullable":true},"value_Amount6":{"type":"number","description":"The monetary amount related to the value code.","format":"double","nullable":true},"value_Amount7":{"type":"number","description":"The monetary amount related to the value code.","format":"double","nullable":true},"value_Amount8":{"type":"number","description":"The monetary amount related to the value code.","format":"double","nullable":true},"value_Amount9":{"type":"number","description":"The monetary amount related to the value code.","format":"double","nullable":true},"value_Code1":{"maxLength":30,"type":"string","description":"The code indicating a monetary condition which was used by the intermediary to process an institutional claim.","nullable":true},"value_Code10":{"maxLength":30,"type":"string","description":"The code indicating a monetary condition which was used by the intermediary to process an institutional claim.","nullable":true},"value_Code11":{"maxLength":30,"type":"string","description":"The code indicating a monetary condition which was used by the intermediary to process an institutional claim.","nullable":true},"value_Code12":{"maxLength":30,"type":"string","description":"The code indicating a monetary condition which was used by the intermediary to process an institutional claim.","nullable":true},"value_Code13":{"maxLength":30,"type":"string","description":"The code indicating a monetary condition which was used by the intermediary to process an institutional claim.","nullable":true},"value_Code14":{"maxLength":30,"type":"string","description":"The code indicating a monetary condition which was used by the intermediary to process an institutional claim.","nullable":true},"value_Code15":{"maxLength":30,"type":"string","description":"The code indicating a monetary condition which was used by the intermediary to process an institutional claim.","nullable":true},"value_Code16":{"maxLength":30,"type":"string","description":"The code indicating a monetary condition which was used by the intermediary to process an institutional claim.","nullable":true},"value_Code17":{"maxLength":30,"type":"string","description":"The code indicating a monetary condition which was used by the intermediary to process an institutional claim.","nullable":true},"value_Code18":{"maxLength":30,"type":"string","description":"The code indicating a monetary condition which was used by the intermediary to process an institutional claim.","nullable":true},"value_Code19":{"maxLength":30,"type":"string","description":"The code indicating a monetary condition which was used by the intermediary to process an institutional claim.","nullable":true},"value_Code2":{"maxLength":30,"type":"string","description":"The code indicating a monetary condition which was used by the intermediary to process an institutional claim.","nullable":true},"value_Code20":{"maxLength":30,"type":"string","description":"The code indicating a monetary condition which was used by the intermediary to process an institutional claim.","nullable":true},"value_Code21":{"maxLength":30,"type":"string","description":"The code indicating a monetary condition which was used by the intermediary to process an institutional claim.","nullable":true},"value_Code22":{"maxLength":30,"type":"string","description":"The code indicating a monetary condition which was used by the intermediary to process an institutional claim.","nullable":true},"value_Code23":{"maxLength":30,"type":"string","description":"The code indicating a monetary condition which was used by the intermediary to process an institutional claim.","nullable":true},"value_Code24":{"maxLength":30,"type":"string","description":"The code indicating a monetary condition which was used by the intermediary to process an institutional claim.","nullable":true},"value_Code3":{"maxLength":30,"type":"string","description":"The code indicating a monetary condition which was used by the intermediary to process an institutional claim.","nullable":true},"value_Code4":{"maxLength":30,"type":"string","description":"The code indicating a monetary condition which was used by the intermediary to process an institutional claim.","nullable":true},"value_Code5":{"maxLength":30,"type":"string","description":"The code indicating a monetary condition which was used by the intermediary to process an institutional claim.","nullable":true},"value_Code6":{"maxLength":30,"type":"string","description":"The code indicating a monetary condition which was used by the intermediary to process an institutional claim.","nullable":true},"value_Code7":{"maxLength":30,"type":"string","description":"The code indicating a monetary condition which was used by the intermediary to process an institutional claim.","nullable":true},"value_Code8":{"maxLength":30,"type":"string","description":"The code indicating a monetary condition which was used by the intermediary to process an institutional claim.","nullable":true},"value_Code9":{"maxLength":30,"type":"string","description":"The code indicating a monetary condition which was used by the intermediary to process an institutional claim.","nullable":true},"void_Check_ID":{"type":"integer","description":"Indicates that this claim was part of a Refund process.","format":"int32","nullable":true},"volume_Override":{"type":"boolean","description":"Notes that the benefit amount, for disability claims, has been manually overridden. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"waiting_Period_Claim":{"type":"boolean","description":"Indicates if this disability payment is a waiting period payment. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"qualifying_Payment_Amount":{"type":"number","format":"double","nullable":true},"override_Qualifying_Payment_Amount":{"type":"boolean"},"override_Qualifying_Payment_Amount_User":{"type":"string","nullable":true},"service_Authorization_Exception_Code":{"type":"string","nullable":true},"repriced_Claim_Reference_Number":{"type":"string","nullable":true},"adjusted_Repriced_Claim_Reference_Number":{"type":"string","nullable":true},"medical_Record_Number":{"type":"string","nullable":true},"payer_Claim_Control_Number":{"type":"string","nullable":true},"other_Payer_Prior_Authorization_Number":{"type":"string","nullable":true},"investigational_Device_Exemption_Identifier":{"type":"string","nullable":true},"patient_Amount_Paid":{"type":"number","format":"double","nullable":true},"patient_Responsibility_Amount":{"type":"number","format":"double","nullable":true},"peer_Review_Authorization_Number":{"type":"string","nullable":true},"auto_Accident_State":{"type":"string","nullable":true},"care_Plan_Oversight_Number":{"type":"string","nullable":true},"referral_Number":{"type":"string","nullable":true},"mammography_Certification_Number":{"type":"string","nullable":true},"medicare_Section_4081_Indicator":{"type":"string","nullable":true},"demonstration_Project_Indicator":{"type":"string","nullable":true},"clinical_Laboratory_Improvement_Amendment_Number":{"type":"string","nullable":true}},"additionalProperties":false}},"components/schemas/ClaimBatchBenefit":{"id":"components/schemas/ClaimBatchBenefit","kind":"json-schema","title":"ClaimBatchBenefit","data":{"type":"object","properties":{"benefit_Code":{"type":"string","nullable":true},"description":{"type":"string","nullable":true}},"additionalProperties":false}},"components/schemas/ClaimBatchDetail":{"id":"components/schemas/ClaimBatchDetail","kind":"json-schema","title":"ClaimBatchDetail","data":{"required":["adjustment_Seq","batch_Claim","batch_Number","billed_Price","buccal","capitation_Claim","claim_Seq","co_Ins_Amt","co_Pay_Amt","coB_Amt","deductible_Amt","discount_Amt","distal","facial","federal_Tax","fica","incisal","interest","labial","lingual","mesial","not_Covered_Amt","occlusal","override_Benefit_Code","override_Co_Ins_Amt","override_Co_Pay_Amt","override_COB_Amt","override_Ded_Credit_Amt","override_Deductible_Amt","override_Federal_Tax","override_Local_Tax","override_Medicare_Tax","override_Not_Covered_Amt","override_Plan_Price","override_Social_Security","override_State_Tax","override_With_Hold_Amt","paid_Amt","partial_Loss","plan_Price","premium_Deduction","principal","root","social_Security","state_Tax","ucR_Price","with_Hold_Amt"],"type":"object","properties":{"batch_Number":{"type":"integer","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References the ClaimBatch.Batch_Number value on the parent record. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"children":[]}]}]}],"format":"int32"},"batch_Claim":{"type":"integer","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References the ClaimBatch.Batch_Claim value on the parent record. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"children":[]}]}]}],"format":"int32"},"claim_Seq":{"maxLength":2,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"In combination with Adjustment_Seq, creates a unique sequence for each service line on this claim."},"children":[]}]}]}]},"adjustment_Seq":{"maxLength":3,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"In combination with Claim_Seq, creates a unique sequence for each service line on this claim. Used to note adjustments, cascading, etc. when utlized. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"children":[]}]}]}]},"ansI_Code":{"maxLength":8,"type":"string","description":"No longer in use.","nullable":true},"apC_Code":{"maxLength":8,"type":"string","description":"The APC code applied to this service if identified for calculation during adjudication.","nullable":true},"account_Key":{"type":"integer","description":"For reference purposes, this hold the individual service line funding payor/account. If multiple payor/accounts are found on different service lines for the same claim, adjudication spits out an error.","format":"int32","nullable":true},"adjusted_From_Adjustment_Line":{"maxLength":3,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References the Adjustment_Seq value on the original claim that this claim is adjusting."},"children":[]}]}]}],"nullable":true},"adjusted_From_Line":{"maxLength":2,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References the Claim_Seq value on the original claim that this claim is adjusting."},"children":[]}]}]}],"nullable":true},"auth_Number":{"maxLength":20,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"The Auth Number for services that require authorization. References Auth.Auth_Number."},"children":[]}]}]}],"nullable":true},"auth_Penalty":{"type":"number","description":"If an Auth Penalty is applied during adjudication, that is housed here.","format":"double","nullable":true},"auth_Required":{"maxLength":1,"type":"string","description":"Notes that this service lines required authorization.","nullable":true},"benefit_Code":{"maxLength":10,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"This is the benefit code assigned to this service line based on the Plan assigned on the Claim header. References BenefitCodes.Benefit_Code."},"children":[]}]}]}],"nullable":true},"benefit_Rate_Applied":{"type":"number","description":"Benefit Rate being applied to this detail line.","format":"double","nullable":true},"billed_Price":{"type":"number","description":"The billed charges assigned by the provider for this service. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"brand_Indicator":{"maxLength":1,"type":"string","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","nullable":true},"buccal":{"type":"boolean","description":"For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"cliA_Number":{"maxLength":32,"type":"string","description":"No longer in use.","nullable":true},"coB_Amt":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Holds the Other Insurance calculated amount that would affect the payable amount for this service (calculated from COB_Hold, COB_Mem_Resp, COB_Savings, and COB_Savings_Used). Note: This field is marked as NOT NULL in the database and therefore required by the API."},"children":[]}]}]}],"format":"double"},"coB_Hold":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied."},"children":[]}]}]}],"format":"double","nullable":true},"coB_Mem_Resp":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied."},"children":[]}]}]}],"format":"double","nullable":true},"coB_Savings":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied."},"children":[]}]}]}],"format":"double","nullable":true},"coB_Savings_Used":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied."},"children":[]}]}]}],"format":"double","nullable":true},"calendar_Year":{"maxLength":4,"type":"string","description":"Used for Flex Claims to indicate the calendar year this claim applies.","nullable":true},"capitation_Claim":{"type":"boolean","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Notes if this service line is captiated. If the Claim.Capitation_Claim value is flagged, it overrides this value and notes the entire claim and all service lines as capitated. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"children":[]}]}]}]},"check_ID":{"type":"integer","description":"No longer in use.","format":"int32","nullable":true},"co_Ins_Amt":{"type":"number","description":"The co-insurance amount applied by adjudication based on benefit definition. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"co_Pay_Amt":{"type":"number","description":"The co-pay amount applied by adjudication based on benefit definition. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"currency_ID":{"maxLength":16,"type":"string","description":"For currency calculations, this holds the destination currency.","nullable":true},"days_Supply":{"type":"integer","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","format":"int32","nullable":true},"ded_Credit_Amt":{"type":"number","description":"If the service is eligiblity for deductible credits, they would be stored here.","format":"double","nullable":true},"deductible_Amt":{"type":"number","description":"The deductible amount applied by adjudication based on benefit definition. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"detail_Plan_Year":{"maxLength":8,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Indicates which Plan Year the service line correlates to from GroupPlanYear.Plan_Year"},"children":[]}]}]}],"nullable":true},"diagnosis_Code":{"maxLength":8,"type":"string","description":"The diagnosis pointer for this service line indicating which Diagnostic Codes from the Claim are applicable to this service.","nullable":true},"discount_Amt":{"type":"number","description":"The difference between Billed and Allowed is stored as the Discount Amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"dispense_As_Written":{"type":"integer","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","format":"int32","nullable":true},"distal":{"type":"boolean","description":"For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"drug_Code":{"maxLength":20,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"For RX claims or medical claims that hold a drug code. References DrugCode.Drug_Code."},"children":[]}]}]}],"nullable":true},"drug_Quantity":{"type":"number","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","format":"double","nullable":true},"entry_Date":{"type":"string","description":"Date when the record was first added to the system.","format":"date-time"},"entry_User":{"maxLength":20,"type":"string","description":"User that first added the record to the system.","nullable":true},"error_Auth":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Benefit":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Count":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Covered":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Dates":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Diagnosis":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_ExCode":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Modifier":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Place":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Price":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"error_Procedure":{"maxLength":1,"type":"string","description":"During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.","nullable":true},"ex_Code":{"maxLength":6,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code."},"children":[]}]}]}],"nullable":true},"ex_Code2":{"maxLength":6,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code."},"children":[]}]}]}],"nullable":true},"ex_Code3":{"maxLength":6,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code."},"children":[]}]}]}],"nullable":true},"fica":{"type":"number","description":"The FICA tax amount for disability claims. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"facial":{"type":"boolean","description":"For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"federal_Amount_To_Tax":{"type":"number","description":"Based on taxable amount and various configurations, this holds the Federal \"To Tax\" amount for disability claim.","format":"double","nullable":true},"federal_Tax":{"type":"number","description":"The calculated Federal tax amount based on the \"To Tax\" amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"federal_Tax_Flat":{"type":"number","description":"A flat federal tax amount applied in addition to the calculated tax amount.","format":"double","nullable":true},"fill_Date":{"type":"string","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","format":"date-time","nullable":true},"flex_Description":{"maxLength":128,"type":"string","description":"Manually entered description of this flex claim.","nullable":true},"formulary_Indicator":{"maxLength":1,"type":"string","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","nullable":true},"incisal":{"type":"boolean","description":"For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"interest":{"type":"number","description":"If interest is calculated on a claim, it is stored here and applied to payable amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"labial":{"type":"boolean","description":"For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"life_Benefit":{"maxLength":10,"type":"string","description":"The Life Benefit to be applied for Life claims processing.","nullable":true},"life_Benefit_Volume":{"type":"number","description":"The Life Benefit calculated volume based on benefit definition.","format":"double","nullable":true},"line_Control_Number":{"maxLength":64,"type":"string","description":"Number added manually to claims and from 837 files and sent outbound on 835 files.","nullable":true},"lingual":{"type":"boolean","description":"For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"local_Tax":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"If a locality tax is applicable it would be housed here. Note: The database will apply a default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"0"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" for this field if a value is not provided."},"children":[]}]}]}],"format":"double","nullable":true},"mail_Order_Indicator":{"maxLength":1,"type":"string","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","nullable":true},"medicare_Amount_To_Tax":{"type":"number","description":"Based on taxable amount and various configurations, this holds the Medicare \"To Tax\" amount for disability claim.","format":"double","nullable":true},"medicare_Tax":{"type":"number","description":"The calculated Medicare tax amount based on the \"To Tax\" amount.","format":"double","nullable":true},"mesial":{"type":"boolean","description":"For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"minutes_Per_Unit":{"type":"number","description":"This is for anesthesia, each Unit of anesthesia is equal to a specific amount of Minutes.","format":"double","nullable":true},"modifier":{"maxLength":8,"type":"string","description":"The modifier applied to this service.","nullable":true},"modifier_2":{"maxLength":8,"type":"string","description":"The modifier applied to this service.","nullable":true},"modifier_3":{"maxLength":8,"type":"string","description":"The modifier applied to this service.","nullable":true},"modifier_4":{"maxLength":8,"type":"string","description":"The modifier applied to this service.","nullable":true},"modifier_Units":{"type":"number","description":"The number of the units from this detail line that comes from the Modifier. This determines pricing for the line.","format":"double","nullable":true},"not_Covered_Amt":{"type":"number","description":"For not covered services, or partially not covered services, this reflects that deduction. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"occlusal":{"type":"boolean","description":"For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"oral_Cavity_Designation_Code_1":{"maxLength":3,"type":"string","description":"For dental claims this holds the oral cavity designation sent on the 837D.","nullable":true},"oral_Cavity_Designation_Code_2":{"maxLength":3,"type":"string","description":"For dental claims this holds the oral cavity designation sent on the 837D.","nullable":true},"oral_Cavity_Designation_Code_3":{"maxLength":3,"type":"string","description":"For dental claims this holds the oral cavity designation sent on the 837D.","nullable":true},"oral_Cavity_Designation_Code_4":{"maxLength":3,"type":"string","description":"For dental claims this holds the oral cavity designation sent on the 837D.","nullable":true},"oral_Cavity_Designation_Code_5":{"maxLength":3,"type":"string","description":"For dental claims this holds the oral cavity designation sent on the 837D.","nullable":true},"other_Deduction_Amount":{"type":"number","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","format":"double","nullable":true},"override_Benefit_Code":{"type":"boolean","description":"This flag indicates if the benefit code has been overridden. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_COB_Amt":{"type":"boolean","description":"Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_Co_Ins_Amt":{"type":"boolean","description":"Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_Co_Pay_Amt":{"type":"boolean","description":"Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_Ded_Credit_Amt":{"type":"boolean","description":"Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_Deductible_Amt":{"type":"boolean","description":"Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_Federal_Tax":{"type":"boolean","description":"Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_Local_Tax":{"type":"boolean","description":"Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_Medicare_Tax":{"type":"boolean","description":"Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_Not_Covered_Amt":{"type":"boolean","description":"Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_Plan_Price":{"type":"boolean","description":"Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_Social_Security":{"type":"boolean","description":"Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_State_Tax":{"type":"boolean","description":"Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_With_Hold_Amt":{"type":"boolean","description":"Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"ppO_Price_Plan_Price_Diff":{"type":"number","description":"Information field used in custom processing and reporting.","format":"double","nullable":true},"paid_Amt":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"The final paid amount for this service line based on allowed amount (Plan_Price) minus all applicable deductions. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"children":[]}]}]}],"format":"double"},"partial_Loss":{"type":"number","description":"The partial loss amount for disability claims. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"payor_ID":{"maxLength":20,"type":"string","description":"For reference purposes, this hold the individual service line funding payor/account. If multiple payor/accounts are found on different service lines for the same claim, adjudication spits out an error.","nullable":true},"pharmacy_Name":{"maxLength":128,"type":"string","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","nullable":true},"place_Of_Service":{"maxLength":5,"type":"string","description":"The place of service for the services being rendered on this service line.","nullable":true},"plan_Price":{"type":"number","description":"The allowed amount for this service based on fee schedule, pricing, repricing, etc. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"premium_Deduction":{"type":"number","description":"The premium deduction amount for disability claims. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"prescriber_ID":{"maxLength":32,"type":"string","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","nullable":true},"prescription_Date":{"type":"string","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","format":"date-time","nullable":true},"prescription_Number":{"maxLength":50,"type":"string","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","nullable":true},"pricing_Method":{"maxLength":8,"type":"string","description":"For reprice claims (typically submitted via 837), this notes the reprice method used to reprice this service line.","nullable":true},"pricing_Rate":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"The rate associated with the reprice method (Pricing_Method)."},"children":[]}]}]}],"format":"double","nullable":true},"principal":{"type":"number","description":"For life claims, this holds the principal amount for reporting. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"procedure_Code":{"maxLength":8,"type":"string","description":"The service being rendered on this claim.","nullable":true},"procedure_Code2":{"maxLength":8,"type":"string","description":"The secondary service being rendered on this claim.","nullable":true},"procedure_Code_Units":{"type":"number","description":"The number of th eunits from this detail line that comes from the Prtocedure Code. This determines pricing for the line.","format":"double","nullable":true},"qualifying_Payment_Amount":{"type":"number","description":"QPA (Qualified Payment Amount) values received in upcoming EDI transactions for the NSA (No Surprise Act) mandate.","format":"double","nullable":true},"reason_Code":{"type":"integer","description":"No longer in use.","format":"int32","nullable":true},"refill_Indicator":{"type":"integer","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","format":"int32","nullable":true},"repriced_Savings_Amount":{"type":"number","description":"Holds the submitted reprice savings amount for services that include this amount in the pricing calculation.","format":"double","nullable":true},"root":{"type":"boolean","description":"For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"service_Date":{"type":"string","description":"The start date of the services being rendered.","format":"date-time","nullable":true},"service_Thru":{"type":"string","description":"The end date of the services being rendered.","format":"date-time","nullable":true},"socSec_Amount_To_Tax":{"type":"number","description":"Based on taxable amount and various configurations, this holds the Social Security \"To Tax\" amount for disability claim.","format":"double","nullable":true},"social_Security":{"type":"number","description":"The calculated Social Security tax amount based on the \"To Tax\" amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"state_Amount_To_Tax":{"type":"number","description":"Based on taxable amount and various configurations, this holds the State \"To Tax\" amount for disability claim.","format":"double","nullable":true},"state_Tax":{"type":"number","description":"The calculated State tax amount based on the \"To Tax\" amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"state_Tax_Flat":{"type":"number","description":"A flat state tax amount applied in addition to the calculated tax amount.","format":"double","nullable":true},"state_Tax_State":{"maxLength":2,"type":"string","description":"When state taxes are calculated, this indicates the state the tax amount was calculated against.","nullable":true},"status_Code":{"maxLength":1,"type":"string","description":"Holds the individaul status of this service line based on Ex Codes. 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Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"unit_Dose":{"type":"integer","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","format":"int32","nullable":true},"unit_Of_Measure":{"maxLength":2,"type":"string","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","nullable":true},"update_Date":{"type":"string","description":"Date when the record was last updated in the system.","format":"date-time"},"update_User":{"maxLength":20,"type":"string","description":"User that last updated the record in the system.","nullable":true},"with_Hold_Amt":{"type":"number","description":"For plans that allow withhold, this amount is used to track that amount. 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References BenefitCodes.Benefit_Code."},"children":[]}]}]}],"nullable":true},"benefit_Rate_Applied":{"type":"number","description":"Benefit Rate being applied to this detail line.","format":"double","nullable":true},"billed_Price":{"type":"number","description":"The billed charges assigned by the provider for this service. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"brand_Indicator":{"maxLength":1,"type":"string","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","nullable":true},"buccal":{"type":"boolean","description":"For dental claims, notes if this surface had services rendered. 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Note: This field is marked as NOT NULL in the database and therefore required by the API."},"children":[]}]}]}],"format":"double"},"coB_Hold":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied."},"children":[]}]}]}],"format":"double","nullable":true},"coB_Mem_Resp":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied."},"children":[]}]}]}],"format":"double","nullable":true},"coB_Savings":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied."},"children":[]}]}]}],"format":"double","nullable":true},"coB_Savings_Used":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied."},"children":[]}]}]}],"format":"double","nullable":true},"calendar_Year":{"maxLength":4,"type":"string","description":"Used for Flex Claims to indicate the calendar year this claim applies.","nullable":true},"capitation_Claim":{"type":"boolean","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Notes if this service line is captiated. If the Claim.Capitation_Claim value is flagged, it overrides this value and notes the entire claim and all service lines as capitated. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"children":[]}]}]}]},"check_ID":{"type":"integer","description":"No longer in use.","format":"int32","nullable":true},"co_Ins_Amt":{"type":"number","description":"The co-insurance amount applied by adjudication based on benefit definition. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"co_Pay_Amt":{"type":"number","description":"The co-pay amount applied by adjudication based on benefit definition. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"currency_ID":{"maxLength":16,"type":"string","description":"For currency calculations, this holds the destination currency.","nullable":true},"days_Supply":{"type":"integer","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","format":"int32","nullable":true},"ded_Credit_Amt":{"type":"number","description":"If the service is eligiblity for deductible credits, they would be stored here.","format":"double","nullable":true},"deductible_Amt":{"type":"number","description":"The deductible amount applied by adjudication based on benefit definition. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"detail_Plan_Year":{"maxLength":8,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Indicates which Plan Year the service line correlates to from GroupPlanYear.Plan_Year"},"children":[]}]}]}],"nullable":true},"diagnosis_Code":{"maxLength":8,"type":"string","description":"The diagnosis pointer for this service line indicating which Diagnostic Codes from the Claim are applicable to this service.","nullable":true},"discount_Amt":{"type":"number","description":"The difference between Billed and Allowed is stored as the Discount Amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"dispense_As_Written":{"type":"integer","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","format":"int32","nullable":true},"distal":{"type":"boolean","description":"For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"drug_Code":{"maxLength":20,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"For RX claims or medical claims that hold a drug code. References DrugCode.Drug_Code."},"children":[]}]}]}],"nullable":true},"drug_Quantity":{"type":"number","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","format":"double","nullable":true},"entry_Date":{"type":"string","description":"Date when the record was first added to the system.","format":"date-time"},"entry_User":{"maxLength":20,"type":"string","description":"User that first added the record to the system.","nullable":true},"ex_Code":{"maxLength":6,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code."},"children":[]}]}]}],"nullable":true},"ex_Code2":{"maxLength":6,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code."},"children":[]}]}]}],"nullable":true},"ex_Code3":{"maxLength":6,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code."},"children":[]}]}]}],"nullable":true},"fica":{"type":"number","description":"The FICA tax amount for disability claims. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"facial":{"type":"boolean","description":"For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"federal_Amount_To_Tax":{"type":"number","description":"Based on taxable amount and various configurations, this holds the Federal \"To Tax\" amount for disability claim.","format":"double","nullable":true},"federal_Tax":{"type":"number","description":"The calculated Federal tax amount based on the \"To Tax\" amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"federal_Tax_Flat":{"type":"number","description":"A flat federal tax amount applied in addition to the calculated tax amount.","format":"double","nullable":true},"fill_Date":{"type":"string","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","format":"date-time","nullable":true},"flex_Description":{"maxLength":128,"type":"string","description":"Manually entered description of this flex claim.","nullable":true},"formulary_Indicator":{"maxLength":1,"type":"string","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","nullable":true},"incisal":{"type":"boolean","description":"For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"interest":{"type":"number","description":"If interest is calculated on a claim, it is stored here and applied to payable amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"labial":{"type":"boolean","description":"For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"life_Benefit":{"maxLength":10,"type":"string","description":"The Life Benefit to be applied for Life claims processing.","nullable":true},"life_Benefit_Volume":{"type":"number","description":"The Life Benefit calculated volume based on benefit definition.","format":"double","nullable":true},"line_Control_Number":{"maxLength":64,"type":"string","description":"Number added manually to claims and from 837 files and sent outbound on 835 files.","nullable":true},"lingual":{"type":"boolean","description":"For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"local_Tax":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"If a locality tax is applicable it would be housed here. Note: The database will apply a default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"0"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" for this field if a value is not provided."},"children":[]}]}]}],"format":"double","nullable":true},"mail_Order_Indicator":{"maxLength":1,"type":"string","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","nullable":true},"medicare_Amount_To_Tax":{"type":"number","description":"Based on taxable amount and various configurations, this holds the Medicare \"To Tax\" amount for disability claim.","format":"double","nullable":true},"medicare_Tax":{"type":"number","description":"The calculated Medicare tax amount based on the \"To Tax\" amount.","format":"double","nullable":true},"mesial":{"type":"boolean","description":"For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"modifier":{"maxLength":8,"type":"string","description":"The modifier applied to this service.","nullable":true},"modifier_2":{"maxLength":8,"type":"string","description":"The modifier applied to this service.","nullable":true},"modifier_3":{"maxLength":8,"type":"string","description":"The modifier applied to this service.","nullable":true},"modifier_4":{"maxLength":8,"type":"string","description":"The modifier applied to this service.","nullable":true},"not_Covered_Amt":{"type":"number","description":"For not covered services, or partially not covered services, this reflects that deduction. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"occlusal":{"type":"boolean","description":"For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"oral_Cavity_Designation_Code_1":{"maxLength":3,"type":"string","description":"For dental claims this holds the oral cavity designation sent on the 837D.","nullable":true},"oral_Cavity_Designation_Code_2":{"maxLength":3,"type":"string","description":"For dental claims this holds the oral cavity designation sent on the 837D.","nullable":true},"oral_Cavity_Designation_Code_3":{"maxLength":3,"type":"string","description":"For dental claims this holds the oral cavity designation sent on the 837D.","nullable":true},"oral_Cavity_Designation_Code_4":{"maxLength":3,"type":"string","description":"For dental claims this holds the oral cavity designation sent on the 837D.","nullable":true},"oral_Cavity_Designation_Code_5":{"maxLength":3,"type":"string","description":"For dental claims this holds the oral cavity designation sent on the 837D.","nullable":true},"other_Deduction_Amount":{"type":"number","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","format":"double","nullable":true},"override_Benefit_Code":{"type":"boolean","description":"This flag indicates if the benefit code has been overridden. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_COB_Amt":{"type":"boolean","description":"Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_Co_Ins_Amt":{"type":"boolean","description":"Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_Co_Pay_Amt":{"type":"boolean","description":"Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_Ded_Credit_Amt":{"type":"boolean","description":"Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_Deductible_Amt":{"type":"boolean","description":"Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_Federal_Tax":{"type":"boolean","description":"Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_Local_Tax":{"type":"boolean","description":"Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_Medicare_Tax":{"type":"boolean","description":"Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_Not_Covered_Amt":{"type":"boolean","description":"Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_Plan_Price":{"type":"boolean","description":"Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_Social_Security":{"type":"boolean","description":"Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_State_Tax":{"type":"boolean","description":"Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"override_With_Hold_Amt":{"type":"boolean","description":"Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"ppO_Price_Plan_Price_Diff":{"type":"number","description":"Information field used in custom processing and reporting.","format":"double","nullable":true},"paid_Amt":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"The final paid amount for this service line based on allowed amount (Plan_Price) minus all applicable deductions. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"children":[]}]}]}],"format":"double"},"partial_Loss":{"type":"number","description":"The partial loss amount for disability claims. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"payor_ID":{"maxLength":20,"type":"string","description":"For reference purposes, this hold the individual service line funding payor/account. If multiple payor/accounts are found on different service lines for the same claim, adjudication spits out an error.","nullable":true},"pharmacy_Name":{"maxLength":128,"type":"string","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","nullable":true},"place_Of_Service":{"maxLength":5,"type":"string","description":"The place of service for the services being rendered on this service line.","nullable":true},"plan_Price":{"type":"number","description":"The allowed amount for this service based on fee schedule, pricing, repricing, etc. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"premium_Deduction":{"type":"number","description":"The premium deduction amount for disability claims. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"prescriber_ID":{"maxLength":32,"type":"string","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","nullable":true},"prescription_Date":{"type":"string","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","format":"date-time","nullable":true},"prescription_Number":{"maxLength":50,"type":"string","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","nullable":true},"pricing_Method":{"maxLength":8,"type":"string","description":"For reprice claims (typically submitted via 837), this notes the reprice method used to reprice this service line.","nullable":true},"pricing_Rate":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"The rate associated with the reprice method (Pricing_Method)."},"children":[]}]}]}],"format":"double","nullable":true},"principal":{"type":"number","description":"For life claims, this holds the principal amount for reporting. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"procedure_Code":{"maxLength":8,"type":"string","description":"The service being rendered on this claim.","nullable":true},"procedure_Code2":{"maxLength":8,"type":"string","description":"The secondary service being rendered on this claim.","nullable":true},"qualifying_Payment_Amount":{"type":"number","description":"QPA (Qualified Payment Amount) values received in upcoming EDI transactions for the NSA (No Surprise Act) mandate.","format":"double","nullable":true},"reason_Code":{"type":"integer","description":"No longer in use.","format":"int32","nullable":true},"refill_Indicator":{"type":"integer","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","format":"int32","nullable":true},"repriced_Savings_Amount":{"type":"number","description":"Holds the submitted reprice savings amount for services that include this amount in the pricing calculation.","format":"double","nullable":true},"root":{"type":"boolean","description":"For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"service_Date":{"type":"string","description":"The start date of the services being rendered.","format":"date-time","nullable":true},"service_Thru":{"type":"string","description":"The end date of the services being rendered.","format":"date-time","nullable":true},"socSec_Amount_To_Tax":{"type":"number","description":"Based on taxable amount and various configurations, this holds the Social Security \"To Tax\" amount for disability claim.","format":"double","nullable":true},"social_Security":{"type":"number","description":"The calculated Social Security tax amount based on the \"To Tax\" amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"state_Amount_To_Tax":{"type":"number","description":"Based on taxable amount and various configurations, this holds the State \"To Tax\" amount for disability claim.","format":"double","nullable":true},"state_Tax":{"type":"number","description":"The calculated State tax amount based on the \"To Tax\" amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"state_Tax_Flat":{"type":"number","description":"A flat state tax amount applied in addition to the calculated tax amount.","format":"double","nullable":true},"state_Tax_State":{"maxLength":2,"type":"string","description":"When state taxes are calculated, this indicates the state the tax amount was calculated against.","nullable":true},"status_Code":{"maxLength":1,"type":"string","description":"Holds the individaul status of this service line based on Ex Codes. A - Payable, D - Denied, E - Pended.","nullable":true},"svc_Count":{"type":"number","description":"The units applied to this service.","format":"double","nullable":true},"taxable_Amount":{"type":"number","description":"This holds the starting taxable amount based on pre-tax and pre-gross deductions applied to this service.","format":"double","nullable":true},"tooth_Number":{"type":"integer","description":"For dental claims, this identifies the tooth, quadrant or arch being worked for this service.","format":"int32","nullable":true},"ucR_Price":{"type":"number","description":"No longer in use. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"double"},"unit_Dose":{"type":"integer","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","format":"int32","nullable":true},"unit_Of_Measure":{"maxLength":2,"type":"string","description":"Pharmacy claim information submitted via file submission and used in reporting and interfaces.","nullable":true},"update_Date":{"type":"string","description":"Date when the record was last updated in the system.","format":"date-time"},"update_User":{"maxLength":20,"type":"string","description":"User that last updated the record in the system.","nullable":true},"with_Hold_Amt":{"type":"number","description":"For plans that allow withhold, this amount is used to track that amount. 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Not to be used externally.","nullable":true},"claim_ID":{"maxLength":32,"type":"string","description":"Archive storage table for tracking initial entry of Claim information. Not to be used externally.","nullable":true},"claim_Priority":{"maxLength":1,"type":"string","description":"Archive storage table for tracking initial entry of Claim information. Not to be used externally.","nullable":true},"claim_Status":{"maxLength":8,"type":"string","description":"Archive storage table for tracking initial entry of Claim information. Not to be used externally.","nullable":true},"claim_Type":{"maxLength":20,"type":"string","description":"Archive storage table for tracking initial entry of Claim information. Not to be used externally.","nullable":true},"closure_Effective_Date":{"type":"string","description":"Archive storage table for tracking initial entry of Claim information. 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Not to be used externally.","nullable":true},"epsdT_Condition_Indicator1":{"maxLength":3,"type":"string","description":"Archive storage table for tracking initial entry of Claim information. Not to be used externally.","nullable":true},"epsdT_Condition_Indicator2":{"maxLength":3,"type":"string","description":"Archive storage table for tracking initial entry of Claim information. Not to be used externally.","nullable":true},"epsdT_Condition_Indicator3":{"maxLength":3,"type":"string","description":"Archive storage table for tracking initial entry of Claim information. Not to be used externally.","nullable":true},"epsdT_Referral_Given":{"maxLength":1,"type":"string","description":"Archive storage table for tracking initial entry of Claim information. Not to be used externally.","nullable":true},"entry_Date":{"type":"string","description":"Archive storage table for tracking initial entry of Claim information. 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Note: This field is marked as NOT NULL in the database and therefore required by the API."},"anesthesia_Round_Precision":{"type":"integer","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"The precision of rounding used for Anesthesia Units Note: The database will apply a default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"0"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" for this field if a value is not provided."},"children":[]}]}]}],"format":"int32","nullable":true},"anesthesia_Round_Type":{"maxLength":16,"type":"string","description":"The type of rounding used for Anesthesia Units","nullable":true},"apply_Multiple_Benefit_ExCode_Manual":{"type":"boolean","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"If Ex Code is set and all benefits match, set to the first benefit code and set the Ex Code.  If Apply_Multiple_Benefit_ExCode_Manual is set to 1 (checked) then the ex code is applied as a Manual ex code, which is not cleared on future adjudications and requires a client to manually clear it Note: This field is marked as NOT NULL in the database and therefore required by the API."},"children":[]}]}]}]},"authReview_Full_Path":{"maxLength":255,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"authReview_Object":{"maxLength":255,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"auth_Code_Closed":{"maxLength":8,"type":"string","description":"If after processing a claim, there are no more remaining units left for an Auth that was used on the claim, set the Auth Code on the Auth to this Code","nullable":true},"auth_Code_Pay_Amt_Zero":{"maxLength":8,"type":"string","description":"When a claim with an auth has a payable amount of zero","nullable":true},"auth_Code_Reopen":{"maxLength":8,"type":"string","description":"If after returning a claim to batch, if there are remaining units left for an Auth that was used on the claim, set the Auth Code on the Auth to this Code","nullable":true},"auth_Code_Under_Auth_Amt":{"maxLength":8,"type":"string","description":"When a claim with an auth has a payable amount under the approved amount on the auth","nullable":true},"auth_Over_Unit_Split_Ex_Code":{"maxLength":8,"type":"string","description":"Ex Code to use when spliting Authorizations","nullable":true},"auth_Penalty_Ex_Code":{"maxLength":6,"type":"string","description":"If filled out and an Auth Penalty is found, insert the Ex Code","nullable":true},"auto_Adj_Return_To_Batch":{"type":"boolean","description":"This flag indicates claims being returned to batch will be automatically adjudicated. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"auto_Pay_Capitated_Claims":{"type":"boolean","description":"Auto pays Capitated claims and Creates a Check Batch Note: This field is marked as NOT NULL in the database and therefore required by the API."},"auto_Process_Adjustment_Backout":{"type":"boolean","description":"Whether or not to automatically process the Backout of a claim after an adjustment Note: This field is marked as NOT NULL in the database and therefore required by the API."},"auto_Term_Plan_On_Gateway_Request":{"type":"boolean","description":"This is a flag indicating that when a Gateway request for coverage is confirmed, if the member has an existing plan of the same plan type, it will be termed. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"bR_Domain_Name":{"maxLength":256,"type":"string","description":"For Bold Reports integration, this identifies the Domain Name.  Used only by VBA developers, not for client use.","nullable":true},"bR_Site_Name":{"maxLength":256,"type":"string","description":"For Bold Reports integration, this identifies the Site Name. Used only by VBA developers, not for client use.","nullable":true},"bR_Site_Secret":{"maxLength":256,"type":"string","description":"For Bold Reports integration, this identifies the Site Secret. Used only by VBA developers, not for client use.","nullable":true},"bR_Site_User":{"maxLength":256,"type":"string","description":"For Bold Reports integration, this identifies the Site User. Used only by VBA developers, not for client use.","nullable":true},"baseLoadFg":{"type":"boolean","description":"Whether or not BaseLoad is turned on","nullable":true},"baseLoadPass":{"maxLength":256,"type":"string","description":"BaseLoad Password","nullable":true},"baseLoadServiceDateFlag":{"type":"boolean","description":"This flag denotes whether or not to include the Service Date within the BaseLoad XML sent to BaseLoad Note: This field is marked as NOT NULL in the database and therefore required by the API."},"baseLoadURL":{"maxLength":8000,"type":"string","description":"BaseLoad URL","nullable":true},"baseLoadUser":{"maxLength":256,"type":"string","description":"BaseLoad User ID","nullable":true},"beneficiary_AgeLimit":{"type":"number","description":"Minimum Age for a Beneficiary","format":"double","nullable":true},"beneficiary_Age_Ex_Code":{"maxLength":8,"type":"string","description":"This pend code will be applied when the beneficiary age defined on the enrollment is invalid.","nullable":true},"benefit_Cascade_Ex_Code":{"maxLength":8,"type":"string","description":"This Informational Ex Code will be applied to a claim detail line when the benefit is defined as cascading in the plan and the necessary criteria have been met to cascade the benefits.","nullable":true},"benefit_Length":{"type":"number","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"double","nullable":true},"bridged_Tooth_Ex_Code":{"maxLength":8,"type":"string","description":"This pend code will be applied when the tooth number on the claim is found to have been previously bridged.","nullable":true},"caS_Segment_Ben_Match":{"type":"boolean","description":"This flag indicates that the adjudication benefit matching will use custom logic for CAS assignments from inbound 837 files.  This option is set and controlled by VBA developers and not for client use. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"cliA_Certificate_Ex_Code":{"maxLength":6,"type":"string","description":"This Denial Ex Code will deny a claim when a CLIA certificate is required and the provider record does not have CLIA certification.","nullable":true},"cmO_Installed":{"maxLength":1,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"cap_By_Service_Line":{"type":"boolean","description":"Claim will error if number of the Claim has Mixed Capitation Service Lines unless this is checked. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"cap_Disenroll_Adj_Reason":{"maxLength":8,"type":"string","description":"Default Capitation Disenroll Adjustment reason","nullable":true},"cap_Enroll_Adj_Reason":{"maxLength":8,"type":"string","description":"Default Capitation Enroll Adjustment reason","nullable":true},"cap_Enrolled_By":{"type":"integer","description":"This setting defines the Enrollment date the application uses for Calculating a Capitated Providers payment.","format":"int32","nullable":true},"cap_Enrolled_Thru":{"type":"integer","description":"This setting defines the Enrollment date the application uses for Calculating a Capitated Providers payment.","format":"int32","nullable":true},"cap_In_Accum":{"type":"boolean","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Not used in system configuration. Used on external and/or custom procedures. Note: The database will apply a default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"False"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" for this field if a value is not provided."},"children":[]}]}]}],"nullable":true},"capitated_Service_Ex_Code":{"maxLength":8,"type":"string","description":"This Informational Ex Code will be applied to a claim detail line when services are Capitated.","nullable":true},"case_Default_Report":{"maxLength":256,"minLength":1,"type":"string","description":"The Default Case Report when using the Case Report functionality from Case Update Note: This field is marked as NOT NULL in the database and therefore required by the API."},"cash_Value_Default":{"type":"integer","description":"Default Issue Duratoin Value for Cash Type","format":"int32","nullable":true},"checkPayeeAddressFlag":{"type":"boolean","description":"When selected, if the payee address is not filled out, error the claim Note: This field is marked as NOT NULL in the database and therefore required by the API."},"check_Stock_Location":{"maxLength":128,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"checks_Max_Post_Date":{"type":"integer","description":"Adds an error during the Check Wizard if the Check Date exceeds the threshold set here","format":"int32","nullable":true},"city":{"maxLength":20,"type":"string","description":"City of the Company's address.","nullable":true},"claimUpload_Date":{"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"date-time","nullable":true},"claimUpload_File_Location":{"maxLength":128,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"claimUpload_Schedule":{"maxLength":1,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"claim_Age_Ex_Code":{"maxLength":6,"type":"string","description":"This Denial Ex Code will deny a claim in which the age definitions of the plan are exceeded.","nullable":true},"claim_Allowed_Billed_Ex_Code":{"maxLength":6,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"claim_Amt_Ex_Code":{"maxLength":6,"type":"string","description":"This pend code will be applied when the claim billed amount exceeds the user max defined on the user information.","nullable":true},"claim_Auth_Denied_Ex_Code":{"maxLength":6,"type":"string","description":"If Filled out and an Auth Status is Denied, insert the Ex Code","nullable":true},"claim_Auth_Details_Err_Ex":{"maxLength":6,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"claim_Auth_Diff_Mem_Ex":{"maxLength":6,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"claim_Auth_Diff_Prov_Ex":{"maxLength":6,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"claim_Auth_Exceeded_Ex_Code":{"maxLength":6,"type":"string","description":"If Filled out and the Auth has exceeded the Approved, insert the Ex Code","nullable":true},"claim_Auth_Invalid_Date_Ex":{"maxLength":6,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"claim_Auth_Not_Approved_Ex":{"maxLength":6,"type":"string","description":"If Filled out and an Auth status is Not Approved, insert the Ex Code","nullable":true},"claim_Auth_Proc_Exceeded_Ex_Code":{"maxLength":8,"type":"string","description":"If filled out and the number of Approved Procedure Units is exceeded, insert the Ex Code","nullable":true},"claim_Auth_Reqd_Ex_Code":{"maxLength":6,"type":"string","description":"If filled out and an Auth is required, insert the Ex Code","nullable":true},"claim_Ben_Not_Found_Ex_Code":{"maxLength":6,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"claim_Cov_In_Net_Only_Ex_Code":{"maxLength":6,"type":"string","description":"Checking this indicates the Benefit is covered only when services are rendered using an In-Network provider.","nullable":true},"claim_Days_Allowed":{"type":"number","description":"Number of claim days allowed.","format":"double","nullable":true},"claim_Dead_Ex_Code":{"maxLength":6,"type":"string","description":"This Denial Ex Code will deny a claim for a member whose enrollment record indicates they are deceased.","nullable":true},"claim_Ded_Credit_OON_Used_Ex_Code":{"maxLength":8,"type":"string","description":"This Ex Code is used when Deductible Credit is used for the claim Out of Network","nullable":true},"claim_Ded_Credit_PPO_Used_Ex_Code":{"maxLength":8,"type":"string","description":"This Ex Code is used when Deductible Credit is used for the claim in Network","nullable":true},"claim_Denied_Ex_Code":{"maxLength":6,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"claim_Diagnosis_Age_Ex_Code":{"maxLength":6,"type":"string","description":"This Ex Code is used when the Age is outside the range for the Diagnosis","nullable":true},"claim_Diagnosis_Gender_Ex_Code":{"maxLength":6,"type":"string","description":"This Ex Code is used when the Gender is not a valid Gender for the Diagnosis","nullable":true},"claim_Dup_Error_Ex_Code":{"maxLength":8,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"claim_Error_Ex_Code":{"maxLength":6,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"claim_Exceed_Daily_CoPay_Max_Ex_Code":{"maxLength":8,"type":"string","description":"if the CoPay has been adjusted due to previous CoPay amounts, Trigger this Ex Code","nullable":true},"claim_Exceed_Injury_Ex_Code":{"maxLength":6,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"claim_Exceed_Lifetime_Ex_Code":{"maxLength":6,"type":"string","description":"This Ex Code is used when the claim exceeds a Lifetime Max Payable","nullable":true},"claim_Exceed_Lifetime_OON_Ex_Code":{"maxLength":8,"type":"string","description":"This Ex Code is used when the Lifetime Max Payable Out of Network has been exceeded","nullable":true},"claim_Exceed_Lifetime_PPO_Ex_Code":{"maxLength":8,"type":"string","description":"This Ex Code is used when the Lifetime Max Payable In Network has been exceeded","nullable":true},"claim_Exceed_Maximum_Ex_Code":{"maxLength":6,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"claim_Exceed_PerDiem_Ex_Code":{"maxLength":6,"type":"string","description":"This Informational Ex Code will be applied to a claim when the Per-Diem amount defined on the provider record has been exceeded.","nullable":true},"claim_Fee_Sched_Error_Ex":{"maxLength":6,"type":"string","description":"This pend code will be applied to a claim when the provider record indicates a fee schedule is required but no fee schedule is assigned to the provider.","nullable":true},"claim_Lag_Error_Ex_Code":{"maxLength":6,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"claim_Late_Ex_Code":{"maxLength":6,"type":"string","description":"This Denial Ex Code will deny a claim that exceeds the timely filing limits set.","nullable":true},"claim_Life_Benefit_Met_Ex_Code":{"maxLength":6,"type":"string","description":"This Ex Code is used when the Life Claim exceeds the Benefits Maximum","nullable":true},"claim_Life_Plan_Met_Ex_Code":{"maxLength":6,"type":"string","description":"This Ex Code is used when the Life Claim exceeds the Plan Maximum","nullable":true},"claim_No_Prov_Fee_Sched":{"maxLength":6,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"claim_No_Rate_Fee_Ex_Code":{"maxLength":8,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"claim_Not_Adult_Dependent":{"maxLength":6,"type":"string","description":"This pend code will be applied to a claim when the date of service exceeds the date on the enrollment record for dependent coverage.","nullable":true},"claim_Not_At_Place_Ex_Code":{"maxLength":6,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"claim_Not_By_Prov_Ex_Code":{"maxLength":6,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"claim_Not_Cov_Ex_Code":{"maxLength":6,"type":"string","description":"This Denial Ex Code will deny a non-covered claim.","nullable":true},"claim_Not_Enrolled_Ex_Code":{"maxLength":6,"type":"string","description":"This Denial Ex Code will deny a claim that comes in for a member that is not enrolled for the date of service.","nullable":true},"claim_Not_Enrolled_Ex_Code_Null_Use_Pre_Post":{"type":"boolean","description":"When selected, instead of using the Not Enrolled Ex Code, put the Pre and Post Enrolled Ex Codes instead Note: This field is marked as NOT NULL in the database and therefore required by the API."},"claim_Not_Enrolled_Post_Ex_Code":{"maxLength":8,"type":"string","description":"This Denial Ex Code will deny a claim if services are after the enrollment date.","nullable":true},"claim_Not_Enrolled_Pre_Ex_Code":{"maxLength":8,"type":"string","description":"This Denial Ex Code will deny a claim if services are prior to the enrollment date.","nullable":true},"claim_Not_Student_Ex_Code":{"maxLength":6,"type":"string","description":"This pend code will be applied to a claim when the date of service exceeds the date on the enrollment record for student coverage.","nullable":true},"claim_Other_Coverage_Ex_Code":{"maxLength":6,"type":"string","description":"This Ex Code is used when the Authorization has Other Coverage Primary selected","nullable":true},"claim_Over_Max_Ex_Code":{"maxLength":6,"type":"string","description":"This Ex Code is used when the claim exceeds an Annual Max Payable","nullable":true},"claim_Over_Max_OON_Ex_Code":{"maxLength":8,"type":"string","description":"This Ex Code is used when the Annual Max Payable Out of Network has been exceeded","nullable":true},"claim_Over_Max_PPO_Ex_Code":{"maxLength":8,"type":"string","description":"This Ex Code is used when the Annual Max Payable In Network has been exceeded","nullable":true},"claim_Pend_Age_Max":{"type":"integer","description":"Trigger the Claim Age Ex Code when the Age of the Patient is above this value","format":"int32","nullable":true},"claim_Pend_Age_Min":{"type":"integer","description":"Trigger the Claim Age Ex Code when the Age of the Patient is below this value","format":"int32","nullable":true},"claim_Pend_Amount":{"type":"number","description":"Trigger the Claim Amt Ex Code when the Claim Payable exceeds this amount","format":"double","nullable":true},"claim_Procedure_Age_Ex_Code":{"maxLength":6,"type":"string","description":"This Denial Ex Code will deny a claim when the procedure code/diagnosis code is defined for a specific age.","nullable":true},"claim_Procedure_Gender_Ex_Code":{"maxLength":6,"type":"string","description":"This Denial Ex Code will deny a claim when the procedure code/diagnosis code is defined for a specific gender.","nullable":true},"claim_Service_Date_Range":{"type":"integer","description":"If outside the payable date range (this value represents days ahead from date of adjudication), error","format":"int32","nullable":true},"claim_Service_Outside_Enrollment_Ex_Code":{"maxLength":6,"type":"string","description":"When a Service Thru date happens outside the normal plan end date","nullable":true},"claim_Splits_Plan_Year_Ex_Code":{"maxLength":8,"type":"string","description":"This Ex Code is used when multiple Plan Years found","nullable":true},"class_Length":{"type":"number","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"double","nullable":true},"clear_Auth_Penalty_ExCode":{"type":"boolean","description":"A flag indicating that any Auth Penalty Ex Code will be removed from a claim line if it has an auth associated. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"client_ID":{"maxLength":6,"type":"string","description":"Client's 3 character ID","nullable":true},"client_Name":{"maxLength":90,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"coIns_Max_Ex_Code":{"maxLength":8,"type":"string","description":"This Informational Ex Code will be applied to a claim when the Subscriber level Coinsurance has been met for the family. An Info code must be applied as a claim detail line may have a partial denial. A deny code will deny the entire line.","nullable":true},"coIns_Max_Ex_Code_Member":{"maxLength":8,"type":"string","description":"This Informational Ex Code will be applied to a claim when the Member Coinsurance has been satisfied. An Info code must be applied as a claim detail line may have a partial denial. A Deny code would deny the entire detail line.","nullable":true},"coPay_By_Billed":{"type":"boolean","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Co-Pay based on Billed Amount rather than Plan_Price Note: This field is marked as NOT NULL in the database and therefore required by the API."},"children":[]}]}]}]},"cogito_App_Client_ID":{"maxLength":128,"type":"string","description":"The app client ID associated with the user pool.  Exclusively for use in VBASoftware and VBAPI Cognito integration with AWS.","nullable":true},"cogito_App_Client_Secret":{"maxLength":256,"type":"string","description":"The app client Secret associated with the user pool. Exclusively for use in VBASoftware and VBAPI Cognito integration with AWS.","nullable":true},"cogito_User_Pool_ID":{"maxLength":64,"type":"string","description":"The ID of the Amazon Cognito user pool.  Exclusively for use in VBASoftware and VBAPI Cognito integration with AWS.","nullable":true},"combined_Notes_Report_Fg":{"type":"boolean","description":"When this flag is set to yes, the notes report from the Notes screen will remove the page breaks Note: This field is marked as NOT NULL in the database and therefore required by the API."},"comm_Disenroll_Adj_Reason":{"maxLength":8,"type":"string","description":"Default Commisssion Disenroll Adjustment Reason","nullable":true},"comm_Enroll_Adj_Reason":{"maxLength":8,"type":"string","description":"Default Commisssion Enroll Adjustment Reason","nullable":true},"comm_Enrolled_By":{"type":"integer","description":"Default Commisssion Enrolled By value","format":"int32","nullable":true},"comm_Enrolled_Thru":{"type":"integer","description":"Default Commisssion Enrolled Thru value","format":"int32","nullable":true},"company_Length":{"type":"number","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"double","nullable":true},"company_Short":{"maxLength":4,"type":"string","description":"Client ID of the Client","nullable":true},"company_Start_Date":{"type":"string","description":"The date used to avoid using data prior to the date the company starts with VBA.","format":"date-time","nullable":true},"context4_ClmUcrPct":{"type":"integer","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"int32","nullable":true},"context4_ClmUcrPct_OON":{"type":"integer","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"int32","nullable":true},"context4_FeeSelector":{"maxLength":8,"type":"string","description":"The type of Fee for Context4 Pricing","nullable":true},"context4_FeeSelector_OON":{"maxLength":8,"type":"string","description":"The type of Fee for Context4 Pricing when OON","nullable":true},"context4_MedicarePct":{"type":"integer","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"int32","nullable":true},"context4_MedicarePct_OON":{"type":"integer","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"int32","nullable":true},"context4_Password":{"maxLength":128,"type":"string","description":"The Password for Context4 Pricing","nullable":true},"context4_PayorType":{"maxLength":8,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"context4_PayorType_OON":{"type":"integer","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"int32","nullable":true},"context4_PctOfChg":{"type":"integer","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"int32","nullable":true},"context4_PctOfChg_OON":{"type":"integer","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"int32","nullable":true},"context4_PlanPriceNotGreaterBilledFg":{"type":"boolean","description":"When set, if Plan Price exceeds Billed Price, set Plan Price equal to Billed Price for Context4 Note: This field is marked as NOT NULL in the database and therefore required by the API."},"context4_SendBillingAddressFg":{"type":"boolean","description":"Whether or not the Billing Address information is sent to Context4 Note: This field is marked as NOT NULL in the database and therefore required by the API."},"context4_UserID":{"maxLength":128,"type":"string","description":"The User ID for Context4 Pricing","nullable":true},"context4_WebURI":{"maxLength":256,"type":"string","description":"The WebURI for Context4 Pricing","nullable":true},"context4_WebURI_Delete":{"maxLength":256,"type":"string","description":"The Delete WebURI for Context4 Pricing","nullable":true},"copay_Ex_Code":{"maxLength":6,"type":"string","description":"The Ex Code to apply when adjudicating a claim that has a copay greater than zero.","nullable":true},"country_ID":{"maxLength":8,"type":"string","description":"Default Country","nullable":true},"credential_By_Payee":{"type":"boolean","description":"Flag to create a row in office location of the provider's practice with data from the corresponding payee record instead of provider. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"credentialing":{"maxLength":1,"type":"string","description":"When selected, turn on Credentialing","nullable":true},"crowned_Tooth_Ex_Code":{"maxLength":8,"type":"string","description":"This pend code will be applied when the tooth number on the claim is found to have been previously crowned.","nullable":true},"currency_Format":{"maxLength":20,"type":"string","description":"Used for currency format when saving to Excel in Formatted","nullable":true},"dB_Version_Date":{"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"date-time","nullable":true},"drG_Schedule":{"maxLength":16,"type":"string","description":"Selection this option will set the default DRG schedule.","nullable":true},"database_Version":{"maxLength":32,"type":"string","description":"Stores the latest Release Version","nullable":true},"date_Format":{"maxLength":20,"type":"string","description":"Date format used when saving reports as formatted Excel","nullable":true},"deductible_Ex_Code":{"maxLength":6,"type":"string","description":"The Ex Code to apply when adjudicating a claim that has a deductible greater than zero.","nullable":true},"deductible_Max_Ex_Code":{"maxLength":8,"type":"string","description":"This Informational Ex Code will be applied to a claim when the Subscriber level deductible has been met for the family. An Info code must be applied as a claim detail line may have a partial denial. A deny code will deny the entire line.","nullable":true},"deductible_Max_Ex_Code_Member":{"maxLength":8,"type":"string","description":"This Informational Ex Code will be applied to a claim when the Member Deductible has been satisfied. An Info code must be applied as a claim detail line may have a partial denial. A Deny code would deny the entire detail line.","nullable":true},"default_1099_Flag":{"maxLength":1,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"default_Auth_Code":{"maxLength":8,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"default_Check_Stock":{"type":"integer","description":"Defines the default check stock.","format":"int32","nullable":true},"default_Currency_ID":{"maxLength":16,"type":"string","description":"Default Currency to be used","nullable":true},"default_EOB_Report":{"type":"integer","description":"Defines the default EOB report.","format":"int32","nullable":true},"default_Federal_Tax":{"type":"number","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"double","nullable":true},"default_Federal_Tax_Day_Limit":{"type":"integer","description":"Default limit to when Federal Tax applies","format":"int32","nullable":true},"default_Federal_Tax_Pct":{"type":"number","description":"The default Federal Tax percentage","format":"double","nullable":true},"default_Federal_Wage_Limit":{"type":"number","description":"Default limit to the amount of wages that can be used to calculate Federal Tax","format":"double","nullable":true},"default_ID_Card_Request_Type":{"maxLength":16,"type":"string","description":"Indicates the desired default format for generated IDs.","nullable":true},"default_Invoice_ReportDefinition_Key":{"type":"integer","description":"A part of invoice Process Automation","format":"int32","nullable":true},"default_Login_Sound":{"maxLength":255,"type":"string","description":"Sets the default login sound.","nullable":true},"default_Medicare_Tax_Day_Limit":{"type":"integer","description":"Default limit to when Medicare Tax applies","format":"int32","nullable":true},"default_Medicare_Wage_Limit":{"type":"number","description":"Default limit to the amount of wages that can be used to calculate Medicare Tax","format":"double","nullable":true},"default_Pay_Date_Range":{"type":"integer","description":"Used to calculate the Check Paid Date","format":"int32","nullable":true},"default_Payor_ID":{"maxLength":10,"type":"string","description":"Payor ID that is defaulted to.","nullable":true},"default_SS_Tax_Day_Limit":{"type":"integer","description":"Default limit to when Social Security Tax applies","format":"int32","nullable":true},"default_SS_Wage_Limit":{"type":"number","description":"Default limit to the amount of wages that can be used to calculate Social Security Tax","format":"double","nullable":true},"default_State_Tax_Day_Limit":{"type":"integer","description":"Default limit to when State Tax applies","format":"int32","nullable":true},"default_State_Wage_Limit":{"type":"number","description":"Default limit to the amount of wages that can be used to calculate State Tax","format":"double","nullable":true},"dental_ATP_Paid_Date_Type":{"maxLength":32,"type":"string","description":"Holds the selected setting for ATP Paid Date on Dental Claims (Standard or by Processed Date)","nullable":true},"diagnostic_Code_Type_Default":{"maxLength":16,"minLength":1,"type":"string","description":"Default Diagnostic Code Type for Disability and Life claims Note: This field is marked as NOT NULL in the database and therefore required by the API."},"disallow_Spec_Char_In_Plan_ID":{"type":"boolean","description":"This flag disallows special characters to be used in the Plan ID column. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"disconnect_Call_Notes_From_Claim_Provider":{"type":"boolean","description":"This is a flag indicating that when viewing notes from Call Tracking, provider and claim notes associated with the call record will not be displayed. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"disenroll_Adj_Reason":{"type":"integer","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"int32","nullable":true},"disenroll_Auth_Code":{"maxLength":8,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"display_PPO_Null_Network":{"type":"boolean","description":"When selected, if the claim is Out of Network, show zero dollars in the PPO Discount Note: This field is marked as NOT NULL in the database and therefore required by the API."},"division_Length":{"type":"number","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"double","nullable":true},"dup_Password_Days":{"type":"integer","description":"Sets the number of days before a password may be duplicated (reused).","format":"int32","nullable":true},"duplicateMaster_Key":{"type":"integer","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Choose the applicable duplicate rule for the application. See Duplicate Sets in Claim Services > Claim Configuration to maintain the Duplicate Rule options."},"children":[]}]}]}],"format":"int32","nullable":true},"edI_Installed":{"maxLength":1,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"eoB_Disclaimer":{"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"eoB_Report_Location":{"maxLength":255,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"eR_Place_Of_Service":{"maxLength":5,"type":"string","description":"Choose the applicable place of service for emergency room services.","nullable":true},"enforce_MFA":{"type":"boolean","description":"Note: This field is marked as NOT NULL in the database and therefore required by the API."},"enroll_Adj_Reason":{"type":"integer","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"int32","nullable":true},"entry_Date":{"type":"string","description":"Date when the record was added to the system.","format":"date-time"},"entry_User":{"maxLength":20,"type":"string","description":"User that first added the record to the system.","nullable":true},"error_Invalid_Diag":{"type":"boolean","description":"Checking this box will cause claims to error if an invalid Diagnosis Code is billed. Left unchecked with a deny Ex Code selected the line item will automatically deny. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"error_Invalid_Proc":{"type":"boolean","description":"Checking this box will cause claims to error if an invalid Procedure Code is billed. Left unchecked with a deny Ex Code selected the line item will automatically deny. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"error_Multiple_Plan_Years":{"type":"boolean","description":"When selected, if there are multiple Plan Years found, error instead of triggering Claim Splits Plan Year Ex Code Note: This field is marked as NOT NULL in the database and therefore required by the API."},"error_Paid_To_Provider":{"type":"boolean","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"If selected and there's no Payee assigned to the Provider, set Send_Check_To Provider Note: The database will apply a default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"False"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" for this field if a value is not provided."},"children":[]}]}]}],"nullable":true},"error_Termed_Provider":{"type":"boolean","description":"Checking this box will cause claims to error if a Termed Provider is selected. Left unchecked with a deny Ex Code selected the claim will automatically deny. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"exceed_Exhaust_Date_Ex_Code":{"maxLength":8,"type":"string","description":"This Ex Code is used when the Service Date exceeds the Exhause Date on a Disability Claim","nullable":true},"exceed_Return_To_Work_Ex_Code":{"maxLength":8,"type":"string","description":"This pend code will be applied when the claim date of service exceeds the date defined as the return to work day on the disability claim.","nullable":true},"exceeds_PaidThrough_Ex_Code":{"maxLength":8,"type":"string","description":"This pend code will be applied when the claim date of service exceeds the paid through date defined on the member record.","nullable":true},"extended_Term_Default":{"type":"integer","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"int32","nullable":true},"fax_Country_Code":{"maxLength":8,"type":"string","description":"Country Code for the fax number of the Subscriber.","nullable":true},"fax_Number":{"maxLength":20,"type":"string","description":"Fax number of the Client.","nullable":true},"federal_ID":{"maxLength":20,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"fee_Sched_Match_Claim_Year":{"type":"boolean","description":"No longer used in the system Note: This field is marked as NOT NULL in the database and therefore required by the API."},"fee_Schedule_Ex_Codes_Manual":{"type":"boolean","description":"When this is checked, Fee Schedule Ex Codes from the FeeSched and FeeSchedDetail tables will be added as MANUAL ex codes.  This means adjudication will not wipe these away at the start of adjudication. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"fee_Schedule_Exact_Match_Fg":{"type":"boolean","description":"Whether or not the Modifiers of a Fee Schedule have to match exact Note: This field is marked as NOT NULL in the database and therefore required by the API."},"filled_Tooth_Ex_Code":{"maxLength":8,"type":"string","description":"Ex Code to set when the member has Filled a Tooth","nullable":true},"first_Benefit_Auto_Selected_Ex_Code":{"maxLength":6,"type":"string","description":"Ex code that is added when a benefit code is automatically selected on a claim detail where multiple benefit codes all match with equivalent payment details","nullable":true},"flex_Claim_After_Grace_Period_Ex_Code":{"maxLength":8,"type":"string","description":"This Ex Code is used when a Flex Claim is submitted after the Grace period","nullable":true},"flex_Claim_After_Submit_Period_Ex_Code":{"maxLength":8,"type":"string","description":"This Ex Code is used when a Flex Claim is submitted after the Submission period","nullable":true},"flex_Claim_Funds_Exhausted_Ex_Code":{"maxLength":8,"type":"string","description":"This Ex Code is used when the Flex Claim has exceeded the balance","nullable":true},"force_Call_Track_Note":{"type":"boolean","description":"Not used in system configuration. Used on external and/or custom procedures. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"force_Claim_Rec_Date":{"type":"boolean","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"If selected, the claim must have a Received_Date,             ELSE it will Error Note: This field is marked as NOT NULL in the database and therefore required by the API."},"children":[]}]}]}]},"force_Claim_Sub_ID":{"maxLength":1,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"force_Latest_Enrollment":{"type":"boolean","description":"Use Latest Enrollment Note: This field is marked as NOT NULL in the database and therefore required by the API."},"force_Leading_Zero_On_Rev_Code":{"type":"boolean","description":"If selected and the procedure code is only 3 length, add a zero to verify the procedure code Note: This field is marked as NOT NULL in the database and therefore required by the API."},"full_Backout_On_Void_Distribution":{"type":"boolean","description":"When selected, Add all the backout Distribution records when voiding a check Note: This field is marked as NOT NULL in the database and therefore required by the API."},"full_Month_Billing":{"maxLength":1,"minLength":1,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"generate_Comm_Date":{"type":"string","description":"Used to stop other users from generating invoices while another user is generating commissions.","format":"date-time","nullable":true},"generate_Comm_User":{"maxLength":16,"type":"string","description":"Used to stop other users from generating invoices while another user is generating commissions.","nullable":true},"generate_Inv_Date":{"type":"string","description":"Used to stop other users from generating invoices while another user is generating invoices","format":"date-time","nullable":true},"generate_Inv_User":{"maxLength":16,"type":"string","description":"Used to stop other users from generating invoices while another user is generating invoices","nullable":true},"generate_Negative_Inv":{"type":"boolean","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Check this checkbox to allow for a negative invoice to create. This will also allow a $0 invoice to create. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"children":[]}]}]}]},"generate_PremDist_After":{"type":"string","description":"When Generating Invoices, look for distributions after this date","format":"date-time","nullable":true},"global_CMU_ID":{"maxLength":16,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"grace_Logins":{"type":"integer","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"int32","nullable":true},"group_Length":{"type":"number","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"double","nullable":true},"iD_Card_Location":{"maxLength":255,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"ivR_CS_Country_Code":{"maxLength":8,"type":"string","description":"Country Code for IVR or Customer Service number.","nullable":true},"ivR_CS_Phone_Number":{"maxLength":20,"type":"string","description":"IVR or Customer Service number of the Client.","nullable":true},"ignore_Care_Management_Hierarchy_Fg":{"type":"boolean","description":"Overrides Case Manager Hierarchy and allows the assigning of cases up or down Note: This field is marked as NOT NULL in the database and therefore required by the API."},"ignore_Claim_Funding_Status_Change_Msg":{"type":"boolean","description":"This is a flag indicating that when changing a claims status in Claim Funding, no message will display warning the user of the existing status. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"inactive_Payee_Ex_Code":{"maxLength":6,"type":"string","description":"When a claim has a Provider using a Payee that is marked as inactive","nullable":true},"include_Invalid_Enrollments":{"type":"boolean","description":"Not used in system configuration. Used on external and/or custom procedures. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"inv_Grace_Period":{"type":"integer","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"int32","nullable":true},"inv_Grace_Period_Type":{"maxLength":1,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"invalid_Diag_Ex_Code":{"maxLength":6,"type":"string","description":"This Ex Code is used when the Diagnosis Code is invalid","nullable":true},"invalid_Proc_Ex_Code":{"maxLength":6,"type":"string","description":"This Ex Code is used when the Procedure Code is invalid","nullable":true},"invoice_Close_Adj_Reason":{"type":"integer","description":"Default reason for Invoice Closed","format":"int32","nullable":true},"invoice_Enrolled_By":{"type":"integer","description":"Date used when configuring Enrolled By Date for Invoices Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"int32"},"invoice_Enrolled_Thru":{"type":"integer","description":"Date used when configuring Enrolled Thru Date for Invoices","format":"int32","nullable":true},"invoice_Grace_Ex_Code":{"maxLength":6,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"invoice_Grace_Period":{"type":"integer","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"int32","nullable":true},"invoice_Remit_Account_Key":{"type":"integer","description":"Default Invoice Remit Account","format":"int32","nullable":true},"invoice_Remit_Address1":{"maxLength":128,"type":"string","description":"Default Invoice Remit Address","nullable":true},"invoice_Remit_Address2":{"maxLength":128,"type":"string","description":"Default Invoice Remit Address2","nullable":true},"invoice_Remit_City":{"maxLength":32,"type":"string","description":"Default Invoice Remit City","nullable":true},"invoice_Remit_Country_Code":{"maxLength":8,"type":"string","description":"Default Invoice Remit Country Code","nullable":true},"invoice_Remit_Country_ID":{"maxLength":8,"type":"string","description":"Default Invoice Remit Country","nullable":true},"invoice_Remit_Name":{"maxLength":128,"type":"string","description":"Default Invoice Remit Name","nullable":true},"invoice_Remit_Phone_Number":{"maxLength":32,"type":"string","description":"Default Invoice Remit Phone Number","nullable":true},"invoice_Remit_State":{"maxLength":2,"type":"string","description":"Default Invoice Remit State","nullable":true},"invoice_Remit_Zip_Code":{"maxLength":32,"type":"string","description":"Default Invoice Remit Zip Code","nullable":true},"lag_Time":{"type":"integer","description":"Not used in system configuration. Used on external and/or custom procedures. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"int32"},"last_Age_Disenroll":{"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"date-time","nullable":true},"last_Authorization":{"type":"integer","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"int32","nullable":true},"last_Billing":{"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"date-time","nullable":true},"last_Case_Number":{"type":"integer","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"int32","nullable":true},"last_Check_Batch":{"type":"integer","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"int32","nullable":true},"last_Claim_Number":{"type":"number","description":"Used to determine the next Claim Number","format":"double","nullable":true},"last_Day_Worked_Range":{"type":"integer","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"int32","nullable":true},"last_Encounter":{"type":"number","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"double","nullable":true},"last_Invoice":{"type":"number","description":"Filled out after an Invoice is generated, likely used for reporting or as a reference","format":"double","nullable":true},"lock_Auth_Review":{"type":"boolean","description":"If selected, only the user that created the Auth Review can update the Auth Review Note: This field is marked as NOT NULL in the database and therefore required by the API."},"lock_Auth_Review_All":{"type":"boolean","description":"When this is checked, Auth Reviews cannot be updated or modified by anyone.  They can still be added. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"log_BaseLoad_Call":{"type":"boolean","description":"Flag that enables the logging of calls to Baseload for provider information Note: This field is marked as NOT NULL in the database and therefore required by the API."},"logo_File":{"maxLength":128,"type":"string","description":"Stores the file location for logos.","nullable":true},"long_State_Names":{"maxLength":1,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"mail_AuthMode":{"type":"integer","description":"Client's e-mail server AuthMode (Not sure, just passed in as general settings)","format":"int32","nullable":true},"mail_Password":{"maxLength":64,"type":"string","description":"Client's e-mail server Password","nullable":true},"mail_Port":{"type":"integer","description":"Client's e-mail server Port","format":"int32","nullable":true},"mail_Server":{"maxLength":128,"type":"string","description":"Client's e-mail server","nullable":true},"mail_Use_SSL":{"type":"boolean","description":"Client's e-mail server SSL setting Note: This field is marked as NOT NULL in the database and therefore required by the API."},"mail_User":{"maxLength":64,"type":"string","description":"Client's e-mail server User Name","nullable":true},"medicare_On_Benefit":{"maxLength":1,"minLength":1,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"member_Address_DOB_Not_Reqd":{"type":"boolean","description":"This flag indicates if a full address and date of birth are not required when creating a new member Note: This field is marked as NOT NULL in the database and therefore required by the API."},"member_Match_By_Name_BirthDate":{"type":"boolean","description":"When selected, adjudication will attempt to match a patient on their First Name, Last Name and Birth Date Note: This field is marked as NOT NULL in the database and therefore required by the API."},"modifier_Not_Eff_Ex_Code":{"maxLength":8,"type":"string","description":"This Denial Ex Code will deny a claim when the modifier entered is not listed as active on the modifier table.","nullable":true},"multiple_Auth_Ex_Code":{"maxLength":6,"type":"string","description":"If filled out and there are multiple Auths that are valid, insert the Ex Code","nullable":true},"name":{"maxLength":60,"type":"string","description":"Name of the Company.","nullable":true},"network_Does_Not_Match_Repriced_Network_Ex_Code":{"maxLength":6,"type":"string","description":"When the Network ID on the claim does not match what the system would have selected, throw this ex code","nullable":true},"new_Member_Reason":{"type":"integer","description":"Reason for the new Member.","format":"int32","nullable":true},"note_Attachment_DB":{"type":"boolean","description":"If selected, Note Attachments will be saved to the Database instead of in a local file location Note: This field is marked as NOT NULL in the database and therefore required by the API."},"note_Attachment_Local_Default":{"maxLength":255,"type":"string","description":"Indicates the local location for note attachments. When a note attachment is opened, it will make a copy from the remote location to the local location before opening the file.","nullable":true},"note_Attachment_Remote_Default":{"maxLength":255,"type":"string","description":"Indicates the remote location where note attachments will be saved. A network location should be populated at this location.","nullable":true},"ooP_Max_Ex_Code":{"maxLength":8,"type":"string","description":"This Ex Code is used when the claim exceeds the OOP Maximum","nullable":true},"ooP_Max_Ex_Code_Member":{"maxLength":8,"type":"string","description":"This Informational Ex Code will be applied to a claim when the Member level out of pocket has been exceeded.","nullable":true},"out_Of_Net_Ex_Code":{"maxLength":8,"type":"string","description":"This Informational Ex Code will be applied to all claims processed as out of network.","nullable":true},"overpayment_Deduction_Type":{"maxLength":8,"type":"string","description":"Override's the default Deduction Type of 502","nullable":true},"pcP_Only_Ex_Code":{"maxLength":8,"type":"string","description":"This Ex Code is used when a Benefit is marked PCP Only and the Member does not have a valid PCP","nullable":true},"partial_Cap":{"type":"boolean","description":"Not used in system configuration. Used on external and/or custom procedures. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"password_Expiration":{"type":"integer","description":"Sets the number of days before password expiration.","format":"int32","nullable":true},"password_Minimum":{"type":"integer","description":"Sets the minimum length required for application passwords.","format":"int32","nullable":true},"pay_Period_Start_Date":{"type":"string","description":"This date is used to calculate the Bill From and Bill Thru dates for invoices using the Calendar Payroll type of Billing Cycle.","format":"date-time","nullable":true},"payment_Proration":{"type":"boolean","description":"Whether or not invoices will be prorated Note: This field is marked as NOT NULL in the database and therefore required by the API."},"phone_Country_Code":{"maxLength":8,"type":"string","description":"Country Code for the phone number of the Subscriber.","nullable":true},"phone_Format":{"maxLength":20,"type":"string","description":"Phone format used when saving reports as formatted Excel","nullable":true},"phone_Number":{"maxLength":20,"type":"string","description":"Phone number of the Client.","nullable":true},"place_Code_Not_Setup_Ex_Code":{"maxLength":6,"type":"string","description":"This Ex Code is used when a Place Code is not valid for an Auth, Benefit, Co Ins or Co Pay","nullable":true},"planBenefit_Override_Network_ID":{"maxLength":10,"type":"string","description":"When Always Pay In Network is checked, if this is filled out and the claim is currently out of network, change the Network ID to this value.","nullable":true},"plan_Length":{"type":"number","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"double","nullable":true},"policy_Forfeiture_Grace_Period":{"type":"integer","description":"Not used in system configuration. Used on external and/or custom procedures.","format":"int32","nullable":true},"policy_Forfeiture_Grace_Period_Type":{"maxLength":1,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"premium_Proration":{"type":"boolean","description":"This flag denotes whether or not Premiums will be prorated when a Member Disenrolls Note: This field is marked as NOT NULL in the database and therefore required by the API."},"prevent_Suspense_Release_By_Process_User":{"type":"boolean","description":"Flag to prevent the same user that processed a claim from releasing it from Claim Suspended status. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"primary_Account_Key":{"type":"integer","description":"This defines the primary bank account.","format":"int32","nullable":true},"process_Auths_When_Pended":{"type":"boolean","description":"When this flag is set to yes, adjudication will process Auths on Pended claims. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"process_Auto_COB":{"type":"boolean","description":"Identifies that the check run process will now create Auto-COB claims if the Secondary member information is configured on a MemberInsruance record. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"processing_Mode":{"maxLength":1,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"prof_ATP_Paid_Date_Type":{"maxLength":32,"type":"string","description":"Holds the selected setting for ATP Paid Date on Professional Claims (Standard or by Processed Date)","nullable":true},"prosthesis_Tooth_Ex_Code":{"maxLength":8,"type":"string","description":"Ex Code to set when the member has used a Prosthesis Tooth","nullable":true},"protect_Alternate_ID":{"type":"boolean","description":"This flag indicates the alternate ID on the member update screen cannot be changed Note: This field is marked as NOT NULL in the database and therefore required by the API."},"provider_Auth_Exempt_Procedure_Ex_Code":{"maxLength":8,"type":"string","description":"If a provider is exempt from Authorizations, throw this ex code","nullable":true},"provider_Not_Active_Auth_Code":{"maxLength":8,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"pulled_Tooth_Ex_Code":{"maxLength":8,"type":"string","description":"This pend code will be applied when the tooth number on the claim is found to have been previously pulled.","nullable":true},"qpA_Method_1_Ex_Code":{"maxLength":6,"type":"string","description":"Ex Code to be applied to claims that use QPA Method 1","nullable":true},"qpA_Method_2_Ex_Code":{"maxLength":6,"type":"string","description":"Ex Code to be applied to claims that use QPA Method 2","nullable":true},"rX_ATP_Paid_Date_Type":{"maxLength":32,"type":"string","description":"Default value for an RX Claim's Paid Date: Service Date, Fill Date or Prescription Date","nullable":true},"reduced_Paid_Up_Default":{"type":"integer","description":"Default Issue Duratoin Value for RPU Type","format":"int32","nullable":true},"reins_Split_Claim":{"type":"boolean","description":"Not used in system configuration. Used on external and/or custom procedures. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"repetitive_Payment":{"type":"boolean","description":"If set to yes, bring up the list of Repetitive Payments on a timer","nullable":true},"repriced_Line":{"maxLength":64,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"request_ID_Card_Prompt_Enrollment":{"type":"boolean","description":"If checked, when the user updates a member record, prompt the user if they want to request a new ID Card. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"request_Provider_Email":{"maxLength":255,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"request_Reassess_Email":{"maxLength":255,"type":"string","description":"Not used in system configuration. Used on external and/or custom procedures.","nullable":true},"restrict_NPI_Federal_ID":{"type":"boolean","description":"This flag indicates the NPI and Federal ID fields on a Provider record have length restrictions of 10/9 characters respectively Note: This field is marked as NOT NULL in the database and therefore required by the API."},"return_To_Work_Range":{"type":"integer","description":"Defined Return to Work Range for a disability claim","format":"int32","nullable":true},"scanned_Images_Folder":{"maxLength":255,"type":"string","description":"Indicates the file location where scanned images are kept.","nullable":true},"set_Paid_Through":{"type":"boolean","description":"If selected, set the Paid Through Date once an invoice is closed Note: This field is marked as NOT NULL in the database and therefore required by the API."},"single_Refund_Check_Batch":{"type":"boolean","description":"If selected put all refunds into the same Check Batch Note: This field is marked as NOT NULL in the database and therefore required by the API."},"state":{"maxLength":2,"type":"string","description":"State of the Company's address.","nullable":true},"subscriber_ID_Format":{"maxLength":20,"type":"string","description":"Not used in system configuration. 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Note: This field is marked as NOT NULL in the database and therefore required by the API."},"children":[]}]}]}],"format":"date-time"},"plan_ID":{"maxLength":20,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References Plans.Plan_ID on the parent record."},"children":[]}]}]}]},"account_Key":{"type":"integer","description":"Identifies the banking account associated with the selected contract.","format":"int32","nullable":true},"advice_To_Pay":{"type":"boolean","description":"When this option is selected, adjudication to mark every claim as 'Advice to Pay' (ATP). Advice to Pay claims do not produce check records when processed. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"bpl":{"maxLength":16,"type":"string","description":"No longer in use.","nullable":true},"billing_Basis":{"maxLength":1,"type":"string","description":"No longer in use.","nullable":true},"calc_Interest":{"type":"boolean","description":"Indicates if interest is to be calculated for this contract plan during check processing. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"calc_Interest_ACH":{"type":"boolean","description":"For ACH payments, Indicates if interest is to be calculated for this contract plan during check processing. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"calc_Interest_ACH_Min":{"type":"number","description":"For ACH payments, If interest is to be calculated, this value determines the minimum interest that can be applied. Any interst calculated below this number is ignored.","format":"double","nullable":true},"calc_Interest_ACH_Network_Option":{"maxLength":16,"type":"string","description":"For ACH payments, Indicates if interest is to be calculated by: N - In Network or O - Out of Network. Leave this blank if interest applies to both.","nullable":true},"calc_Interest_ACH_On_Adj":{"type":"boolean","description":"For ACH payments, Flag indicating if interest should be calculated on adjustment claims. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"calc_Interest_ACH_Option":{"maxLength":16,"type":"string","description":"For ACH payments, Indicates what field will be used for interest calculation: B - Billed Amount, A - Allowed Amount or P - Paid Amount.","nullable":true},"calc_Interest_ACH_Pct":{"type":"number","description":"For ACH payments, Indicates the interest percentage to be applied during interest calculations.","format":"double","nullable":true},"calc_Interest_ACH_Prompt_Pay_Freq":{"type":"integer","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"For ACH payments, This is the frequency of \"Calc_Interest_Prompt_Pay_Type\" for determining if interest is applicable."},"children":[]}]}]}],"format":"int32","nullable":true},"calc_Interest_ACH_Prompt_Pay_Type":{"maxLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"For ACH payments, This is the \"Calc_Interest_Prompt_Pay_Freq\" in number of: D - Days, M - Months or Y - Years."},"children":[]}]}]}],"nullable":true},"calc_Interest_Min":{"type":"number","description":"If interest is to be calculated, this value determines the minimum interest that can be applied. Any interst calculated below this number is ignored.","format":"double","nullable":true},"calc_Interest_Network_Option":{"maxLength":16,"type":"string","description":"Indicates if interest is to be calculated by: N - In Network or O - Out of Network. Leave this blank if interest applies to both.","nullable":true},"calc_Interest_On_Adj":{"type":"boolean","description":"Flag indicating if interest should be calculated on adjustment claims. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"calc_Interest_Option":{"maxLength":16,"type":"string","description":"Indicates what field will be used for interest calculation: B - Billed Amount, A - Allowed Amount or P - Paid Amount.","nullable":true},"calc_Interest_Pct":{"type":"number","description":"Indicates the interest percentage to be applied during interest calculations.","format":"double","nullable":true},"calc_Interest_Prompt_Pay_Freq":{"type":"integer","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"This is the frequency of \"Calc_Interest_Prompt_Pay_Type\" for determining if interest is applicable."},"children":[]}]}]}],"format":"int32","nullable":true},"calc_Interest_Prompt_Pay_Type":{"maxLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"This is the \"Calc_Interest_Prompt_Pay_Freq\" in number of: D - Days, M - Months or Y - Years."},"children":[]}]}]}],"nullable":true},"dependent_Contribution":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"For flex, determines the Dependent Contribution amount (or Pct if \"Dependent_Contribution_Pct\" is flagged)"},"children":[]}]}]}],"format":"double","nullable":true},"dependent_Contribution_Pct":{"type":"boolean","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"For flex, notes if the amount entered into \"Dependent_Contribution\" is a percent or flat amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"children":[]}]}]}]},"disability_Pay_Through_Day":{"type":"integer","description":"This is the day number of the week that disability claims created through the disability advisor will run through. This allows a disability claim with an ETD that ends in the middle of a week to be pushed through the end of that week if needed.","format":"int32","nullable":true},"employee_Contribution":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"For flex, determines the Employee Contribution amount (or Pct if \"Employee_Contribution_Pct\" is flagged)"},"children":[]}]}]}],"format":"double","nullable":true},"employee_Contribution_Pct":{"type":"boolean","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"For flex, notes if the amount entered into \"Employee_Contribution\" is a percent or flat amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"children":[]}]}]}]},"end_Coverage_Age":{"type":"integer","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"This is the age of the subscribers on the day based on \"End_Coverage_Age_Type\" before benefits are no longer eligible."},"children":[]}]}]}],"format":"int32","nullable":true},"end_Coverage_Age_Type":{"maxLength":16,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"The type of age in years entered in \"End_Coverage_Age\" by type: EXACTDATE - Age Exact Date, BEGINMONTH - Age at Beginning of month, ENDMONTH - Age at End of month, BEGINYEAR - Age at the beginning of the year, or ENDYEAR - Age at the End of the year."},"children":[]}]}]}],"nullable":true},"entry_Date":{"type":"string","description":"Date when the record was first added to the system.","format":"date-time"},"entry_User":{"maxLength":20,"type":"string","description":"User that first added the record to the system.","nullable":true},"exempt_Federal":{"type":"boolean","description":"Indicates a federal exemption as part of the selected contract. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"exempt_Medicare":{"type":"boolean","description":"indicates a medicare exemption as part of the selected contract. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"exempt_SocSec":{"type":"boolean","description":"Indicates a social security exemption as part of the selected contract. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"exempt_State":{"type":"boolean","description":"Indicates a state exemption as part of the selected contract. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"federal_Tax_Day_Limit":{"type":"integer","description":"Limit of days for the federal tax exemption.","format":"int32","nullable":true},"federal_Wage_Limit":{"type":"number","description":"Wage limit for the federal tax exemption.","format":"double","nullable":true},"locator":{"maxLength":16,"type":"string","description":"No longer in use.","nullable":true},"medicare_Tax_Day_Limit":{"type":"integer","description":"Limit of days for the medicare tax exemption.","format":"int32","nullable":true},"medicare_Wage_Limit":{"type":"number","description":"Wage liimit for the medicare tax exemption.","format":"double","nullable":true},"minimum_Benefit":{"type":"number","description":"For disability claims, this indicates the minimum benefit (weekly for STD plans or monthly for LTD plans).","format":"double","nullable":true},"paid_Through":{"type":"string","description":"Premium Billing setting that holds the premiums paid through for a selection of contracted subscribers.","format":"date-time","nullable":true},"payor_ID":{"maxLength":20,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References PayorAccount.Payor_ID value on parent record."},"children":[]}]}]}],"nullable":true},"prorate_FICA":{"type":"boolean","description":"Notes if Disability Claims should Prorate the FICA tax based on the disability payment duration. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"rX_BIN":{"maxLength":64,"type":"string","description":"Information fields used to hold RX information on this Contract Plan for reporting and interfaces.","nullable":true},"rX_CS_Contact":{"maxLength":128,"type":"string","description":"Information fields used to hold RX information on this Contract Plan for reporting and interfaces.","nullable":true},"rX_CS_Phone":{"maxLength":32,"type":"string","description":"Information fields used to hold RX information on this Contract Plan for reporting and interfaces.","nullable":true},"rX_GRP":{"maxLength":64,"type":"string","description":"Information fields used to hold RX information on this Contract Plan for reporting and interfaces.","nullable":true},"rX_Name":{"maxLength":512,"type":"string","description":"Information fields used to hold RX information on this Contract Plan for reporting and interfaces.","nullable":true},"rX_PCN":{"maxLength":64,"type":"string","description":"Information fields used to hold RX information on this Contract Plan for reporting and interfaces.","nullable":true},"retirement_Plan":{"type":"boolean","description":"Flag to indicate if this plan on this contract is a retirement plan. This is information only. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"salary_Pct":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"If \"Use_Salary_Pct\" option is enabled, this indicatres the percent of salary."},"children":[]}]}]}],"format":"double","nullable":true},"socSec_Tax_Day_Limit":{"type":"integer","description":"Limit of days for the social security tax exemption.","format":"int32","nullable":true},"socSec_Wage_Limit":{"type":"number","description":"Wage limite for Social Security tax exemption.","format":"double","nullable":true},"state_Tax_Day_Limit":{"type":"integer","description":"Limit of days for the state tax exemption.","format":"int32","nullable":true},"state_Wage_Limit":{"type":"number","description":"Wage limit for the state tax exemption.","format":"double","nullable":true},"tax_Day_Limit_Type":{"type":"integer","description":"Indicates if the tax day limitations are by day or calendar months.  The database default for this field is '1'.  Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"int32"},"update_Date":{"type":"string","description":"Date when the record was last updated in the system.","format":"date-time"},"update_User":{"maxLength":20,"type":"string","description":"User that last updated the record in the system.","nullable":true},"use_Plan_Options":{"type":"boolean","description":"Used on the front end to indicate if the plan options should be shown to the user, has not backend functional impact. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"use_Salary_Pct":{"type":"boolean","description":"Indicates that disability should be based upon salary percentage. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"volume":{"type":"number","description":"No longer in use.","format":"double","nullable":true},"volume_Max":{"type":"number","description":"Indicates the benefit maximum of the disabiltiy plan.","format":"double","nullable":true},"volume_Min":{"type":"number","description":"Indicates the benefit minimum of the disability plan.","format":"double","nullable":true},"pay_To_Subscriber_Payee_ID":{"type":"string","nullable":true}},"additionalProperties":false}},"components/schemas/GroupContractPlanListVBAResponse":{"id":"components/schemas/GroupContractPlanListVBAResponse","kind":"json-schema","title":"GroupContractPlanListVBAResponse","data":{"type":"object","properties":{"data":{"type":"array","items":{"$ref":"#/components/schemas/GroupContractPlan"},"nullable":true},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/GroupContractPlanPremium":{"id":"components/schemas/GroupContractPlanPremium","kind":"json-schema","title":"GroupContractPlanPremium","data":{"required":["adult","billing_Basis","child","coverage_Start","division_ID","group_ID","groupContractPlanPremium_Key","plan_ID"],"type":"object","properties":{"groupContractPlanPremium_Key":{"type":"integer","description":"No longer in use. Replaced by Premium Billing module. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"int32"},"adult":{"type":"boolean","description":"No longer in use. Replaced by Premium Billing module. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"age_From":{"type":"integer","description":"No longer in use. Replaced by Premium Billing module.","format":"int32","nullable":true},"age_Thru":{"type":"integer","description":"No longer in use. Replaced by Premium Billing module.","format":"int32","nullable":true},"applies_To":{"maxLength":8,"type":"string","description":"No longer in use. Replaced by Premium Billing module.","nullable":true},"billing_Basis":{"maxLength":1,"minLength":1,"type":"string","description":"No longer in use. Replaced by Premium Billing module."},"child":{"type":"boolean","description":"No longer in use. Replaced by Premium Billing module. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"coverage_Start":{"type":"string","description":"No longer in use. Replaced by Premium Billing module. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"date-time"},"division_ID":{"maxLength":20,"minLength":1,"type":"string","description":"No longer in use. Replaced by Premium Billing module."},"entry_Date":{"type":"string","description":"No longer in use. Replaced by Premium Billing module.","format":"date-time"},"entry_User":{"maxLength":20,"type":"string","description":"No longer in use. Replaced by Premium Billing module.","nullable":true},"group_ID":{"maxLength":20,"minLength":1,"type":"string","description":"No longer in use. Replaced by Premium Billing module."},"maximum":{"type":"number","description":"No longer in use. Replaced by Premium Billing module.","format":"double","nullable":true},"plan_ID":{"maxLength":20,"minLength":1,"type":"string","description":"No longer in use. Replaced by Premium Billing module."},"premium":{"type":"number","description":"No longer in use. Replaced by Premium Billing module.","format":"double","nullable":true},"sex":{"maxLength":1,"type":"string","description":"No longer in use. Replaced by Premium Billing module.","nullable":true},"tier":{"maxLength":2,"type":"string","description":"No longer in use. Replaced by Premium Billing module.","nullable":true},"update_Date":{"type":"string","description":"No longer in use. Replaced by Premium Billing module.","format":"date-time"},"update_User":{"maxLength":20,"type":"string","description":"No longer in use. Replaced by Premium Billing module.","nullable":true}},"additionalProperties":false}},"components/schemas/GroupContractPlanPremiumListVBAResponse":{"id":"components/schemas/GroupContractPlanPremiumListVBAResponse","kind":"json-schema","title":"GroupContractPlanPremiumListVBAResponse","data":{"type":"object","properties":{"data":{"type":"array","items":{"$ref":"#/components/schemas/GroupContractPlanPremium"},"nullable":true},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/GroupContractPlanPremiumVBAResponse":{"id":"components/schemas/GroupContractPlanPremiumVBAResponse","kind":"json-schema","title":"GroupContractPlanPremiumVBAResponse","data":{"type":"object","properties":{"data":{"$ref":"#/components/schemas/GroupContractPlanPremium"},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/GroupContractPlanRider":{"id":"components/schemas/GroupContractPlanRider","kind":"json-schema","title":"GroupContractPlanRider","data":{"required":["benefit_Code","coverage_Start","division_ID","employee_Contribution_Pct","group_ID","plan_ID","use_Salary_Pct"],"type":"object","properties":{"group_ID":{"maxLength":20,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References GroupContractPlan.Group_ID value on the parent record."},"children":[]}]}]}]},"division_ID":{"maxLength":20,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References GroupContractPlan.Division_ID value on the parent record."},"children":[]}]}]}]},"coverage_Start":{"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References GroupContractPlan.Coverage_Start value on the parent record. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"children":[]}]}]}],"format":"date-time"},"plan_ID":{"maxLength":20,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References GroupContractPlan.Plan_ID value on the parent record."},"children":[]}]}]}]},"benefit_Code":{"maxLength":10,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"This is the rider being offered for this plan on this contract. The rider is pulled from the list of PlanBenefits with a Rider value = 1."},"children":[]}]}]}]},"combined_Volume_Max":{"type":"number","description":"For disability claims this will work with the individual volume max for each payment and set a total max for all payments. The rest are not covered.","format":"double","nullable":true},"employee_Contribution":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"For flex, determines the Employee Contribution amount (or Pct if \"Employee_Contribution_Pct\" is flagged)"},"children":[]}]}]}],"format":"double","nullable":true},"employee_Contribution_Pct":{"type":"boolean","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"For flex, notes if the amount entered into \"Employee_Contribution\" is a percent or flat amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"children":[]}]}]}]},"entry_Date":{"type":"string","description":"Date when the record was first added to the system.","format":"date-time"},"entry_User":{"maxLength":20,"type":"string","description":"User that first added the record to the system.","nullable":true},"funding_Indicator":{"maxLength":1,"type":"string","description":"Information only, used in custom client reporting.","nullable":true},"minimum_Benefit":{"type":"number","description":"This is the minimum benefit assigned to each disability payment in all benefit calculations (working with volume minimum).","format":"double","nullable":true},"premium":{"type":"number","description":"No longer in use.","format":"double","nullable":true},"salary_Pct":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"If \"Use_Salary_Pct\" is selected, this is the percentage."},"children":[]}]}]}],"format":"double","nullable":true},"update_Date":{"type":"string","description":"Date when the record was last updated in the system.","format":"date-time"},"update_User":{"maxLength":20,"type":"string","description":"User that last updated the record in the system.","nullable":true},"use_Salary_Pct":{"type":"boolean","description":"Indicates if a percent of salary should be used when determing this benefit amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"volume":{"type":"number","description":"For disability enrollment, this shows the weekly (for STD) or monthly (for LTD) benefit amount.","format":"double","nullable":true},"volume_Max":{"type":"number","description":"When using a salary based benefit, this indicates the max volume (benefit amount) for that calculation.","format":"double","nullable":true},"volume_Min":{"type":"number","description":"When using a salary based benefit, this indicates the minimum volume (benefit amount) for that calculation.","format":"double","nullable":true}},"additionalProperties":false}},"components/schemas/GroupContractPlanRiderExternalID":{"id":"components/schemas/GroupContractPlanRiderExternalID","kind":"json-schema","title":"GroupContractPlanRiderExternalID","data":{"required":["benefit_Code","coverage_Start","division_ID","external_ID","group_ID","plan_ID"],"type":"object","properties":{"group_ID":{"maxLength":20,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References GroupContractPlanRider.Group_ID value on the parent record."},"children":[]}]}]}]},"division_ID":{"maxLength":20,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References GroupContractPlanRider.Division_ID value on the parent record."},"children":[]}]}]}]},"coverage_Start":{"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References GroupContractPlanRider.Coverage_Start value on the parent record. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"children":[]}]}]}],"format":"date-time"},"plan_ID":{"maxLength":20,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References GroupContractPlanRider.Plan_ID value on the parent record."},"children":[]}]}]}]},"benefit_Code":{"maxLength":10,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References GroupContractPlanRider.Benefit_Code value on the parent record."},"children":[]}]}]}]},"external_ID":{"maxLength":32,"minLength":1,"type":"string","description":"The external ID used for custom tax reporting integrations."},"entry_Date":{"type":"string","description":"Date when the record was first added to the system.","format":"date-time"},"entry_User":{"maxLength":20,"type":"string","description":"User that first added the record to the system.","nullable":true},"update_Date":{"type":"string","description":"Date when the record was last updated in the system.","format":"date-time"},"update_User":{"maxLength":20,"type":"string","description":"User that last updated the record in the 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GroupContract.Group_ID value on the parent record."},"children":[]}]}]}]},"division_ID":{"maxLength":20,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References GroupContract.Division_ID value on the parent record."},"children":[]}]}]}]},"coverage_Start":{"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References GroupContract.Coverage_Start value on the parent record. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"children":[]}]}]}],"format":"date-time"},"tier":{"maxLength":2,"minLength":1,"type":"string","description":"The tier being offered during this contract. References Tiers.Tier value in referenced table."},"entry_Date":{"type":"string","description":"Date when the record was first added to the system.","format":"date-time"},"entry_User":{"maxLength":20,"type":"string","description":"User that first added the record to the system.","nullable":true},"update_Date":{"type":"string","description":"Date when the record was last updated in the system.","format":"date-time"},"update_User":{"maxLength":20,"type":"string","description":"User that last updated the record in the 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Group this Day Interval belongs to"},"interval_Year":{"type":"integer","description":"Which Year this Group Day Interval is Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"int32"},"interval_Month":{"type":"integer","description":"Which Month this Group Day Interval is Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"int32"},"interval_Day":{"type":"integer","description":"Which Day this Group Day Interval is Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"int32"},"entry_Date":{"type":"string","description":"Date record was first added to the system","format":"date-time"},"entry_User":{"maxLength":20,"type":"string","description":"User that first added the record to the system","nullable":true},"payday":{"type":"boolean","description":"Whether or not the date this record belongs to is a Payday or not Note: This field is marked as NOT NULL in the database and therefore required by the API."},"update_Date":{"type":"string","description":"Date the record was last updated in the system","format":"date-time"},"update_User":{"maxLength":20,"type":"string","description":"User that last updated the record in the system","nullable":true}},"additionalProperties":false}},"components/schemas/GroupDayIntervalListVBAResponse":{"id":"components/schemas/GroupDayIntervalListVBAResponse","kind":"json-schema","title":"GroupDayIntervalListVBAResponse","data":{"type":"object","properties":{"data":{"type":"array","items":{"$ref":"#/components/schemas/GroupDayInterval"},"nullable":true},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/GroupDayIntervalVBAResponse":{"id":"components/schemas/GroupDayIntervalVBAResponse","kind":"json-schema","title":"GroupDayIntervalVBAResponse","data":{"type":"object","properties":{"data":{"$ref":"#/components/schemas/GroupDayInterval"},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/GroupDivision":{"id":"components/schemas/GroupDivision","kind":"json-schema","title":"GroupDivision","data":{"required":["auth_Not_Reqd_Override","cobrA_Division","coE_Network","division_ID","duplicate_Claim_Override","exempt_Federal","exempt_Medicare","exempt_SocSec","exempt_State","ficA_Employer_Match","generate_W2","group_ID","mail_To_Default","prorate_Deduction","set_Paid_Through","tax_Day_Limit_Type","use_Restricted_Deductions"],"type":"object","properties":{"group_ID":{"maxLength":20,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References Groups.Group_ID value on parent record."},"children":[]}]}]}]},"division_ID":{"maxLength":20,"minLength":1,"type":"string","description":"Unique Division identifier assigned inside this Group. This ID must be unique within the Group ID."},"acH_Account_Key":{"type":"integer","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References the FundingAccount.Account_Key that holds the ACH information for this Division for any ACH processing."},"children":[]}]}]}],"format":"int32","nullable":true},"account_Key":{"type":"integer","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References the PayorAccount.Account_Key value in parent table."},"children":[]}]}]}],"format":"int32","nullable":true},"address":{"maxLength":255,"type":"string","description":"Address associated with the Division.","nullable":true},"address2":{"maxLength":128,"type":"string","description":"Address 2 associated with the Division.","nullable":true},"adult_Age":{"type":"integer","description":"Identifies the age at which dependents are considered to be adults. Student status information is required on the enrollment to allow claims to pay for a dependent whose age exceeds the age defined here.","format":"int32","nullable":true},"agri_Tax_Return":{"maxLength":3,"type":"string","description":"Information field for custom client reporting.","nullable":true},"auth_Not_Reqd_Override":{"type":"boolean","description":"This flag tells adjudication to not error if no authorization is found on claims that require authorization. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"brokerage":{"maxLength":256,"type":"string","description":"Information field for custom client reporting.","nullable":true},"cobrA_Auto_Term_Adj_Reason":{"type":"integer","description":"When utilizing the Auto-Term process, notes the adjustment reason applied to premiums impacted by a retro term.","format":"int32","nullable":true},"cobrA_Auto_Term_Reason":{"type":"integer","description":"When utilizing the Auto-Term process, indicates the Term Reason to apply if COBRA is being enrolled.","format":"int32","nullable":true},"cobrA_Division":{"type":"boolean","description":"Points to the Division ID that is the COBRA Division for this Division. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"coE_Network":{"type":"boolean","description":"Information field for custom client reporting. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"caseRate":{"type":"number","description":"Information field for custom client reporting.","format":"double","nullable":true},"city":{"maxLength":25,"type":"string","description":"City of the Division address.","nullable":true},"claim_Days_Allowed":{"type":"integer","description":"No longer in use.","format":"int32","nullable":true},"class_Description":{"maxLength":128,"type":"string","description":"No longer in use, replaced by GroupClass table.","nullable":true},"class_ID":{"maxLength":20,"type":"string","description":"No longer in use, replaced by GroupClass table.","nullable":true},"contact_Country_Code":{"maxLength":8,"type":"string","description":"Country Code for the Contact Phone Number.","nullable":true},"contact_Email_Address":{"maxLength":128,"type":"string","description":"The division contact email address.","nullable":true},"contact_Extension":{"maxLength":6,"type":"string","description":"The contacts extension for their phone number.","nullable":true},"contact_Phone":{"maxLength":20,"type":"string","description":"The Contact Phone number for this Divisions Contact.","nullable":true},"contact_Title":{"maxLength":20,"type":"string","description":"Title of the Division's primary contact.","nullable":true},"country_ID":{"maxLength":8,"type":"string","description":"Country ID associated with the Division.","nullable":true},"county_Code":{"maxLength":8,"type":"string","description":"County code of the Division address.","nullable":true},"cutoff_Age":{"type":"integer","description":"Identifies the age at which dependents are no longer eligible for coverage. Adult Dependent information is required on the enrollment to allow claims to pay for a dependent whose age exceeds the age defined here.","format":"int32","nullable":true},"default_COBRA_Reason":{"type":"integer","description":"When disenrolling a member and reenrolling into COBRA, this indicates the default reason attached to the disenroll.","format":"int32","nullable":true},"default_Invoice_ReportDefinition_Key":{"type":"integer","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"For reports in the \"INV\" Report_Category, this provides the user with the list of invoice reports they can set as the default report using for automated invoice generation."},"children":[]}]}]}],"format":"int32","nullable":true},"disability_Pay_Through_Day":{"type":"integer","description":"Indicates the day of the week the paid through is set when using automatic paid through dates.","format":"int32","nullable":true},"disenroll_Date":{"type":"string","description":"This notes that the Division has been terminated and what date. An active Division has a NULL value here.","format":"date-time","nullable":true},"distribution_Account_Key":{"type":"integer","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References the PayorAccount.Account_Key value in parent table."},"children":[]}]}]}],"format":"int32","nullable":true},"distribution_Payor_ID":{"maxLength":20,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References the PayorAccount.Payor_ID value in parent table."},"children":[]}]}]}],"nullable":true},"duplicate_Claim_Override":{"type":"boolean","description":"This flag tells adjudication to ignore Duplicate Claims Processing logic if enabled. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"entry_Date":{"type":"string","description":"Date when the record was first added to the system.","format":"date-time"},"entry_User":{"maxLength":20,"type":"string","description":"User that first added the record to the system.","nullable":true},"exempt_Federal":{"type":"boolean","description":"For Disability tax calculations, this indicates if the Division is exempt from taking Federal taxes on the claim payments. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"exempt_Medicare":{"type":"boolean","description":"For Disability tax calculations, this indicates if the Division is exempt from taking Medicare taxes on the claim payments. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"exempt_SocSec":{"type":"boolean","description":"For Disability tax calculations, this indicates if the Division is exempt from taking Social Security taxes on the claim payments. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"exempt_State":{"type":"boolean","description":"For Disability tax calculations, this indicates if the Division is exempt from taking State taxes on the claim payments. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"ficA_Employer_Match":{"type":"boolean","description":"Notes if the employer matches FICA (lowers that tax to 0) during claims adjudication. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"fax":{"maxLength":20,"type":"string","description":"The fax number for this Division.","nullable":true},"fax_Country_Code":{"maxLength":8,"type":"string","description":"Country Code for the Division Fax Number.","nullable":true},"federal_ID":{"maxLength":20,"type":"string","description":"This Division Tax ID.","nullable":true},"federal_Tax_Day_Limit":{"type":"integer","description":"Limit of days for the federal tax exemption.","format":"int32","nullable":true},"federal_Wage_Limit":{"type":"number","description":"Wage limit for the federal tax exemption.","format":"double","nullable":true},"generate_W2":{"type":"boolean","description":"Notes if this Division is part of tax reporting and should have its data sent for W2 generation. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"groupDivisionCaptive":{"maxLength":256,"type":"string","description":"Information field for custom client reporting.","nullable":true},"invoice_Grace_Period":{"type":"integer","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Indicates the grace period for invoice generation for this Division. This value works with \"Invoice_Grace_Period_Type\" to determine duration."},"children":[]}]}]}],"format":"int32","nullable":true},"invoice_Grace_Period_Ex_Code":{"maxLength":6,"type":"string","description":"When a grace period is applied to an invoice that impacts \"Paid Through\", the affected claims will apply this Ex Code.","nullable":true},"invoice_Grace_Period_Type":{"maxLength":16,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Based on \"Invoice_Grace_Period\", this is the Days, Weeks, Months or Years that grace period extends."},"children":[]}]}]}],"nullable":true},"invoice_Level":{"maxLength":1,"type":"string","description":"Indiciates the level of invoicing done by premium billing. There are 3 levels you can configure: S - Subscriber level invoicing (meaning an invoice per enrolled Subscriber), D - Division level invoicing (meaning an invoice per Division with all enrolled Subscribers in that Division on that Invoice), and G - Group level invoicing (meaning an invoice for the whole group with all enrolled Subscribers on the same invoice).","nullable":true},"invoice_Remit_Address1":{"maxLength":128,"type":"string","description":"When generating Division level invoices through premium biling, this is the Address on that invoice.","nullable":true},"invoice_Remit_Address2":{"maxLength":128,"type":"string","description":"When generating Division level invoices through premium biling, this is the Address 2 on that invoice.","nullable":true},"invoice_Remit_City":{"maxLength":32,"type":"string","description":"When generating Division level invoices through premium biling, this is the City on that invoice.","nullable":true},"invoice_Remit_Country_Code":{"maxLength":8,"type":"string","description":"When generating Division level invoices through premium biling, this is the Phone Number Country Code on that invoice.","nullable":true},"invoice_Remit_Country_ID":{"maxLength":8,"type":"string","description":"When generating Division level invoices through premium biling, this is the Country ID on that invoice.","nullable":true},"invoice_Remit_Name":{"maxLength":128,"type":"string","description":"When generating Division level invoices through premium biling, this is the Name on that invoice.","nullable":true},"invoice_Remit_Phone_Number":{"maxLength":32,"type":"string","description":"When generating Division level invoices through premium biling, this is the Phone Number on that invoice.","nullable":true},"invoice_Remit_State":{"maxLength":2,"type":"string","description":"When generating Division level invoices through premium biling, this is the State on that invoice.","nullable":true},"invoice_Remit_Zip_Code":{"maxLength":32,"type":"string","description":"When generating Division level invoices through premium biling, this is the Zip Code on that invoice.","nullable":true},"issue_State":{"maxLength":2,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"For Life & Disability clients, this holds the issue state for processing taxes and reporting."},"children":[]}]}]}],"nullable":true},"mail_To_Default":{"type":"boolean","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"For Life & Disability clients, this is the default Mail To setting applied to claims created through the advisor wizards. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"children":[]}]}]}]},"medicare_Tax_Day_Limit":{"type":"integer","description":"Limit of days for the medicare tax exemption.","format":"int32","nullable":true},"medicare_Wage_Limit":{"type":"number","description":"Wage liimit for the medicare tax exemption.","format":"double","nullable":true},"name":{"maxLength":50,"type":"string","description":"Name of the Group Division.","nullable":true},"notes":{"type":"string","description":"No longer in use. Replaced by the Notes module.","nullable":true},"numberLives":{"type":"integer","description":"Information field for custom client reporting.","format":"int32","nullable":true},"original_Date":{"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"This is the first start date (original effective date) of the Division inside this group. This date should be equal to or earlier than the first GroupContact.Coverage_Start date attached to this Division."},"children":[]}]}]}],"format":"date-time","nullable":true},"other_Insurance_ExCode":{"maxLength":6,"type":"string","description":"This is the Ex Code applied if COB is identified during adjudciation and Other Insurance information is used during processing.","nullable":true},"paid_Through":{"type":"string","description":"This is the paid through date for any Division level invoices through premium billing. This can be manually set or updated by the system.","format":"date-time","nullable":true},"participationIncentive_ID":{"maxLength":32,"type":"string","description":"Information field for custom client reporting.","nullable":true},"pay_To_Account":{"type":"integer","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"For processing that uses the Pay To Account, this referneces the FundingAccount.Account_Key for that process."},"children":[]}]}]}],"format":"int32","nullable":true},"payor_ID":{"maxLength":20,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References the PayorAccount.Payor_ID value in parent table."},"children":[]}]}]}],"nullable":true},"pend_Ex_Code":{"maxLength":6,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"The Ex Code applied during claims adjudication if \"Pend_Flag\" is enabled."},"children":[]}]}]}],"nullable":true},"pend_Flag":{"maxLength":1,"type":"string","description":"Notes that this Division should have a pend code (Ex Code) applied during claims processing for any claims for this Division.","nullable":true},"phone":{"maxLength":20,"type":"string","description":"The phone number for this Division.","nullable":true},"phone_Country_Code":{"maxLength":8,"type":"string","description":"Country Code for the Division Phone Number.","nullable":true},"premium_Location":{"maxLength":50,"type":"string","description":"No longer in use.","nullable":true},"primary_Contact":{"maxLength":25,"type":"string","description":"Primary contact of the Division.","nullable":true},"prorate_Deduction":{"type":"boolean","description":"Notes if this division should have disability deductions pro-rated during claims processing. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"prorate_Deduction_Type":{"maxLength":10,"type":"string","description":"Indicates the type of prorating to calculate against. If calculating against flat deduction types only, set to F, to apply prorating to Percentage based deductions, set to P, if applying prorating on all deduction types, set to B.","nullable":true},"reference_Based_Pricing":{"maxLength":1,"type":"string","description":"Information field for custom client reporting.","nullable":true},"region_Code":{"maxLength":32,"type":"string","description":"Information field for noting the region for this Division.","nullable":true},"reinsurance_Option":{"maxLength":256,"type":"string","description":"No longer in use. 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Replaces by the full reinsurance module.","nullable":true},"state":{"maxLength":2,"type":"string","description":"State of the Division address.","nullable":true},"state_Tax_Day_Limit":{"type":"integer","description":"Limit of days for the state tax exemption.","format":"int32","nullable":true},"state_Wage_Limit":{"type":"number","description":"Wage limit for the state tax exemption.","format":"double","nullable":true},"tax_Day_Limit_Type":{"type":"integer","description":"Indicates if the tax day limitations are by day or calendar months. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"int32"},"transplantElite":{"maxLength":256,"type":"string","description":"Information field for custom client reporting.","nullable":true},"update_Date":{"type":"string","description":"Date when the record was last updated in the system.","format":"date-time"},"update_User":{"maxLength":20,"type":"string","description":"User that last updated the record in the system.","nullable":true},"use_Restricted_Deductions":{"type":"boolean","description":"Limits the deduction types that can be selected on disability claims to use the GroupDivisionDeductionType list. 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Impacts which network is selected during network assignment during adjudication.","format":"int32","nullable":true},"process_As_OON":{"type":"boolean","description":"No longer in use. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"update_Date":{"type":"string","description":"Date when the record was last updated in the system.","format":"date-time"},"update_User":{"maxLength":20,"type":"string","description":"User that last updated the record in the system.","nullable":true}},"additionalProperties":false}},"components/schemas/GroupNetworkAddOn":{"id":"components/schemas/GroupNetworkAddOn","kind":"json-schema","title":"GroupNetworkAddOn","data":{"required":["discount_Payment_Pct","discount_Threshold_Pct","group_ID","groupNetworkAddOn_Key","incurred_From","network_ID"],"type":"object","properties":{"groupNetworkAddOn_Key":{"type":"integer","description":"Used in custom client processing with no functional impact on existing processing. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"int32"},"description":{"maxLength":512,"type":"string","description":"Used in custom client processing with no functional impact on existing processing.","nullable":true},"discount_Payment":{"type":"number","description":"Used in custom client processing with no functional impact on existing processing.","format":"double","nullable":true},"discount_Payment_Pct":{"type":"boolean","description":"Used in custom client processing with no functional impact on existing processing. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"discount_Threshold":{"type":"number","description":"Used in custom client processing with no functional impact on existing processing.","format":"double","nullable":true},"discount_Threshold_Pct":{"type":"boolean","description":"Used in custom client processing with no functional impact on existing processing. 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If so, use Incurred_From and Incurred_Thru values. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"children":[]}]}]}]},"check_Received":{"type":"boolean","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Indiciates if Received_Date should be interrogated for this setting. If so, use Received_From and Received_Thru values. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"children":[]}]}]}]},"currency_ID":{"maxLength":16,"type":"string","description":"If this payor/account setting should be applied only to specific currency, you would note that currency here.","nullable":true},"description":{"maxLength":512,"type":"string","description":"A brief description of this payor/account setting for reporting and admin purposes.","nullable":true},"division_ID":{"maxLength":20,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Optionally, set the Division_ID (reference GroupDivision.Division_ID) if this setting is Division level."},"children":[]}]}]}],"nullable":true},"entry_Date":{"type":"string","description":"Date when the record was first added to the 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GroupPayorAccount.Group_ID on the parent record."},"children":[]}]}]}]},"setting_ID":{"maxLength":32,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References GroupPayorAccount.Setting_ID on the parent record."},"children":[]}]}]}]},"plan_Type":{"maxLength":6,"minLength":1,"type":"string","description":"If the setting is Plan Type specific, you would include that Plan Type 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GroupPayorAccount.Group_ID on the parent record."},"children":[]}]}]}]},"setting_ID":{"maxLength":32,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References GroupPayorAccount.Setting_ID on the parent record."},"children":[]}]}]}]},"federal_ID":{"maxLength":20,"minLength":1,"type":"string","description":"If the setting is Tax ID specific, you would include that Tax ID here."}},"additionalProperties":false}},"components/schemas/GroupPayorAccountProviderFederalListVBAResponse":{"id":"components/schemas/GroupPayorAccountProviderFederalListVBAResponse","kind":"json-schema","title":"GroupPayorAccountProviderFederalListVBAResponse","data":{"type":"object","properties":{"data":{"type":"array","items":{"$ref":"#/components/schemas/GroupPayorAccountProviderFederal"},"nullable":true},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/GroupPayorAccountProviderFederalVBAResponse":{"id":"components/schemas/GroupPayorAccountProviderFederalVBAResponse","kind":"json-schema","title":"GroupPayorAccountProviderFederalVBAResponse","data":{"type":"object","properties":{"data":{"$ref":"#/components/schemas/GroupPayorAccountProviderFederal"},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/GroupPayorAccountSender":{"id":"components/schemas/GroupPayorAccountSender","kind":"json-schema","title":"GroupPayorAccountSender","data":{"required":["group_ID","sender_ID","setting_ID"],"type":"object","properties":{"group_ID":{"maxLength":20,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References GroupPayorAccount.Group_ID on the parent record."},"children":[]}]}]}]},"setting_ID":{"maxLength":32,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References GroupPayorAccount.Setting_ID on the parent record."},"children":[]}]}]}]},"sender_ID":{"maxLength":15,"minLength":1,"type":"string","description":"If the setting is Sender ID (x12 837) specific, you would include that Sender ID here."}},"additionalProperties":false}},"components/schemas/GroupPayorAccountSenderListVBAResponse":{"id":"components/schemas/GroupPayorAccountSenderListVBAResponse","kind":"json-schema","title":"GroupPayorAccountSenderListVBAResponse","data":{"type":"object","properties":{"data":{"type":"array","items":{"$ref":"#/components/schemas/GroupPayorAccountSender"},"nullable":true},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/GroupPayorAccountSenderVBAResponse":{"id":"components/schemas/GroupPayorAccountSenderVBAResponse","kind":"json-schema","title":"GroupPayorAccountSenderVBAResponse","data":{"type":"object","properties":{"data":{"$ref":"#/components/schemas/GroupPayorAccountSender"},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/GroupPayorAccountVBAResponse":{"id":"components/schemas/GroupPayorAccountVBAResponse","kind":"json-schema","title":"GroupPayorAccountVBAResponse","data":{"type":"object","properties":{"data":{"$ref":"#/components/schemas/GroupPayorAccount"},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/GroupPlanYear":{"id":"components/schemas/GroupPlanYear","kind":"json-schema","title":"GroupPlanYear","data":{"required":["division_ID","group_ID","plan_Year","qtr4_Accum","qtr4_Deductible","qtr4_Member","qtr4_Out_Of_Pocket","qtr4_Subscriber"],"type":"object","properties":{"group_ID":{"maxLength":20,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References GroupDivision.Group_ID value on the parent record."},"children":[]}]}]}]},"division_ID":{"maxLength":20,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References GroupDivision.Division_ID value on the parent record."},"children":[]}]}]}]},"plan_Year":{"maxLength":8,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"User defined Plan Year value for this accumulator period. Should denote the values in From_Date and Thru_Date. Example: Plan Year \"CY2009\" would be 1/1/2009 - 12/31/2009."},"children":[]}]}]}]},"entry_Date":{"type":"string","description":"Date when the record was first added to the system.","format":"date-time"},"entry_User":{"maxLength":20,"type":"string","description":"User that first added the record to the system.","nullable":true},"ex_Code":{"maxLength":6,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"If an Ex_Code should be applied when a claim is identified for carry over, place that here."},"children":[]}]}]}],"nullable":true},"from_Date":{"type":"string","description":"The date range for this Plan Year.","format":"date-time","nullable":true},"plan_Type":{"maxLength":6,"type":"string","description":"If this Plan Year is specific to a Plan Type, you would denote that here. Normally no value is set for standard accumulation.","nullable":true},"qtr4_Accum":{"type":"boolean","description":"Indicates if this Plan Year has 4th quarter carry-over. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"qtr4_Benefit_Code":{"maxLength":10,"type":"string","description":"When accumulators are carried over they are bucketed into a single Benefit Code (typically a shell Benefit Code to catch the carry-over dollars).","nullable":true},"qtr4_Deductible":{"type":"boolean","description":"Indicates if carry-over applies to Deductible. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"qtr4_From_Date":{"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"If this Plan Year has 4th quarter carrry-over, this would indiate the dates, inside From_Date and Thru_Date, that signify the 4th quarter carry-over period."},"children":[]}]}]}],"format":"date-time","nullable":true},"qtr4_Member":{"type":"boolean","description":"Indicates if the carry-over applies to Member level accumulators. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"qtr4_Out_Of_Pocket":{"type":"boolean","description":"Indicates if carry-over applies to Out of Pocket. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"qtr4_Out_Of_Pocket_Type":{"maxLength":16,"type":"string","description":"If Out of Pocket carry-over is flagged, this identifies what constitutes Out of Pocket (Deductible, Co-Ins, Co-Pay).","nullable":true},"qtr4_PlanYear":{"maxLength":8,"type":"string","description":"Indicates which Plan Year these carry-over accumulators will carry over to (typically a plan year on the other side of the carry-over period).","nullable":true},"qtr4_Subscriber":{"type":"boolean","description":"Indicates if the carry-over applies to the entire Family for accumulators. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"qtr4_Thru_Date":{"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"If this Plan Year has 4th quarter carrry-over, this would indiate the dates, inside From_Date and Thru_Date, that signify the 4th quarter carry-over period."},"children":[]}]}]}],"format":"date-time","nullable":true},"thru_Date":{"type":"string","description":"The date range for this Plan Year.","format":"date-time","nullable":true},"update_Date":{"type":"string","description":"Date when the record was last updated in the system.","format":"date-time"},"update_User":{"maxLength":20,"type":"string","description":"User that last updated the record in the system.","nullable":true}},"additionalProperties":false}},"components/schemas/GroupPlanYearAutoPriorAccum":{"id":"components/schemas/GroupPlanYearAutoPriorAccum","kind":"json-schema","title":"GroupPlanYearAutoPriorAccum","data":{"required":["division_ID","group_ID","groupPlanYearAutoPriorAccum_Key","plan_Type","plan_Year","prior_Accum_Plan_Type"],"type":"object","properties":{"groupPlanYearAutoPriorAccum_Key":{"type":"integer","description":"Unique identifer for each auto prior accum configuration. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"int32"},"division_ID":{"maxLength":20,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References GroupPlanYear.Division_ID value on the parent record."},"children":[]}]}]}]},"entry_Date":{"type":"string","description":"Date when the record was first added to the system.","format":"date-time"},"entry_User":{"maxLength":20,"type":"string","description":"User that first added the record to the system.","nullable":true},"group_ID":{"maxLength":20,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References GroupPlanYear.Group_ID value on the parent record."},"children":[]}]}]}]},"plan_Type":{"maxLength":6,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References GroupPlanYear.Plan_Type value on the parent record."},"children":[]}]}]}]},"plan_Year":{"maxLength":20,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References GroupPlanYear.Plan_Year value on the parent record."},"children":[]}]}]}]},"prior_Accum_Benefit_Code":{"maxLength":10,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"When auto prior accums are set, this indicates the Benefit_Code value to be written to the prior accum record."},"children":[]}]}]}],"nullable":true},"prior_Accum_Plan_Type":{"maxLength":6,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"When auto prior accums are set, this indicates the Plan_Type value to be written to the prior accum record."},"children":[]}]}]}]},"update_Date":{"type":"string","description":"Date when the record was last updated in the system.","format":"date-time"},"update_User":{"maxLength":20,"type":"string","description":"User that last updated the record in the 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Groups.Group_ID value on the parent record."},"children":[]}]}]}]},"reportDefinition_Key":{"type":"integer","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References ReportDefinition.ReportDefinition_Key on the referenced record. This is the report (of Report_Category \"INV\") that will have a dynamic sequence of premrate categories."},"children":[]}]}]}],"format":"int32"},"premRate_Category":{"maxLength":32,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References PremRateCategory.PremRate_Category on the referenced record. This si the category that will be sequenced on a \"INV\" report."},"children":[]}]}]}]},"sequence":{"type":"integer","description":"The suquence of this Category on the \"INV\" report.","format":"int32"}},"additionalProperties":false}},"components/schemas/GroupPremRateCategoryListVBAResponse":{"id":"components/schemas/GroupPremRateCategoryListVBAResponse","kind":"json-schema","title":"GroupPremRateCategoryListVBAResponse","data":{"type":"object","properties":{"data":{"type":"array","items":{"$ref":"#/components/schemas/GroupPremRateCategory"},"nullable":true},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/GroupPremRateCategoryVBAResponse":{"id":"components/schemas/GroupPremRateCategoryVBAResponse","kind":"json-schema","title":"GroupPremRateCategoryVBAResponse","data":{"type":"object","properties":{"data":{"$ref":"#/components/schemas/GroupPremRateCategory"},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/GroupPriceAdjust":{"id":"components/schemas/GroupPriceAdjust","kind":"json-schema","title":"GroupPriceAdjust","data":{"required":["effective_Date","group_ID"],"type":"object","properties":{"group_ID":{"maxLength":20,"minLength":1,"type":"string","description":"Used in custom client processing with no functional impact on existing processing."},"effective_Date":{"type":"string","description":"Used in custom client processing with no functional impact on existing processing. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"date-time"},"entry_Date":{"type":"string","description":"Date when the record was first added to the system.","format":"date-time"},"entry_User":{"maxLength":20,"type":"string","description":"User that first added the record to the system.","nullable":true},"price_Adjust":{"type":"number","description":"Used in custom client processing with no functional impact on existing processing.","format":"double","nullable":true},"term_Date":{"type":"string","description":"Used in custom client processing with no functional impact on existing processing.","format":"date-time","nullable":true},"update_Date":{"type":"string","description":"Date when the record was last updated in the system.","format":"date-time"},"update_User":{"maxLength":20,"type":"string","description":"User that last updated the record in the system.","nullable":true}},"additionalProperties":false}},"components/schemas/GroupPriceAdjustListVBAResponse":{"id":"components/schemas/GroupPriceAdjustListVBAResponse","kind":"json-schema","title":"GroupPriceAdjustListVBAResponse","data":{"type":"object","properties":{"data":{"type":"array","items":{"$ref":"#/components/schemas/GroupPriceAdjust"},"nullable":true},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/GroupPriceAdjustVBAResponse":{"id":"components/schemas/GroupPriceAdjustVBAResponse","kind":"json-schema","title":"GroupPriceAdjustVBAResponse","data":{"type":"object","properties":{"data":{"$ref":"#/components/schemas/GroupPriceAdjust"},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/GroupSelfAdmin":{"id":"components/schemas/GroupSelfAdmin","kind":"json-schema","title":"GroupSelfAdmin","data":{"required":["active","group_ID","groupSelfAdmin_Key","use_Volume_Scale"],"type":"object","properties":{"groupSelfAdmin_Key":{"type":"integer","description":"Unique identifier for each Self Admin configuration. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"int32"},"active":{"type":"boolean","description":"Notes if this coniguration is active for calculation. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"age":{"type":"integer","description":"The age for this invoice calculation.","format":"int32","nullable":true},"benefit_Code":{"maxLength":10,"type":"string","description":"If there is Benefit level configuration, you would apply that here. If blank, this configuration applies to all benefits inside the group.","nullable":true},"dependents":{"type":"integer","description":"The dependent count for this invoice calculation.","format":"int32","nullable":true},"division_ID":{"maxLength":20,"type":"string","description":"If there is Division level configuration, you would apply that here. If blank, this confiruation applies to the entire group.","nullable":true},"entry_Date":{"type":"string","description":"User that first added the record to the system.","format":"date-time"},"entry_User":{"maxLength":20,"type":"string","description":"Date when the record was first added to the system.","nullable":true},"group_ID":{"maxLength":20,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References Groups.Group_ID values on parent record."},"children":[]}]}]}]},"invoice_Level":{"maxLength":1,"type":"string","description":"Notes the invoice level for self-admin invoicing. Works smilar to GroupDivision setting in that it combines other self-admin confiration to the common level.","nullable":true},"members":{"type":"integer","description":"The member count for this invoice calculation.","format":"int32","nullable":true},"plan_ID":{"maxLength":20,"type":"string","description":"If there is Plan level configuration, you would apply that here. If blank, this configuration applies to all plans inside the group.","nullable":true},"sex":{"maxLength":1,"type":"string","description":"The gender for this invoice calculation.","nullable":true},"subscribers":{"type":"integer","description":"The subscriber count for this invoice calculation.","format":"int32","nullable":true},"update_Date":{"type":"string","description":"User that last updated the record in the system.","format":"date-time"},"update_User":{"maxLength":20,"type":"string","description":"Date when the record was last updated in the system.","nullable":true},"use_Volume_Scale":{"type":"boolean","description":"Indicates if volume scale determines the volume for this invoice calculation. 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Note: This field is marked as NOT NULL in the database and therefore required by the API."},"state_Percentage_Election":{"type":"boolean","description":"Member's election percentage at the state level as listed on the Member's tax documents. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"state_Tax_Exempt":{"type":"boolean","description":"Member's tax exemption status as listed on the Member's tax documents. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"state_Withholding":{"type":"number","description":"Holds a numeric value listed as withholding, used in conjunction with Tax Control.","format":"double","nullable":true},"subscriber_ID":{"maxLength":9,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References Members.Subscriber_ID value on the parent record."},"children":[]}]}]}],"nullable":true},"tax_Exempt":{"type":"boolean","description":"Member's exemption status as listed on the Member's tax documents. 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Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"int32"},"claim_Entered":{"type":"boolean","description":"Identifies that the information was automatically entered based upon claim information. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"entry_Date":{"type":"string","description":"Date when the record was first added to the system.","format":"date-time"},"entry_User":{"maxLength":20,"type":"string","description":"User that first added the record to the system.","nullable":true},"member_Seq":{"maxLength":2,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References Members.Member_Seq value on the parent record."},"children":[]}]}]}]},"subscriber_ID":{"maxLength":9,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References Members.Subscriber_ID value on the parent record."},"children":[]}]}]}]},"tooth_Number":{"type":"integer","description":"Identifies the number of the tooth/teeth that the User intends to change the status of. 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Note: This field is marked as NOT NULL in the database and therefore required by the API."},"continue_Coverage_End_Date":{"type":"string","description":"End date of the 'Continued Coverage' period.","format":"date-time","nullable":true},"continue_Coverage_Ex_Code":{"maxLength":6,"type":"string","description":"Allows for an Ex Code to be assigned when a claim is processed after the disenroll date but within the 'Continue Coverage' period.","nullable":true},"coverage_Type":{"maxLength":32,"type":"string","description":"Indicates the type of coverage ('Open Enrollment', 'Late Enrollment', etc.).","nullable":true},"credible_Coverage":{"type":"integer","description":"Total number of days for the Credible Coverage period.","format":"int32","nullable":true},"creditable_Coverage_End":{"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"End date of the Member's 'Credible Coverage' period. 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This list is only available when copying into an existing plan where \nthe BenefitCode propery is the benefit to be copied and the list of benefits is the destination of that BenefitCode.  \nWhen copying into a new plan, the benefit code is specified in the BenefitCode property.","nullable":true}},"additionalProperties":false}},"components/schemas/PlanBenefitLevel":{"id":"components/schemas/PlanBenefitLevel","kind":"json-schema","title":"PlanBenefitLevel","data":{"required":["benefit_Code","benefit_Level","exclude","planBenefitLevel_Key"],"type":"object","properties":{"planBenefitLevel_Key":{"type":"integer","description":"Unique idenfitier assigned to the Plan Benefit Level. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"int32"},"benefit_Code":{"maxLength":50,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References the PlanBenefits.Benefit_Code value in parent table."},"children":[]}]}]}]},"benefit_Level":{"maxLength":32,"minLength":1,"type":"string","description":"Unique identifier assigned to the Plan Benefit Level: Age by Service Date - age of the Member by the service date of the claim. Age by Received Date - age of the Member by the received date of the claim. Relationship Code - relationship of the Member to the Subscriber. Months Enrolled in Plan - range of months the Member has been enrolled in the plan. Days Enrolled in Plan - range of days the Member has been enrolled in the plan. Network - network of the claim. Out of Network - claim is out of network. Billed Amount - range of billed amount of the service line. Modifier - modifier exists on the service line. Exact Modifier - modifier exists in the exact location on the service line. No Modifier - no modifier exists on the service line. Exclude Modifier - modifier does not exist on the service line. Exclude Exact Modifier - modifier does not exist in the exact location on the service line. Gender - biological sex of the Member. Billing Taxonomy - taxonomy of the billing Provider must be included in the taxonomy group. Rendering Taxonomy - taxonomy of the rendering Provider must be included in the taxonomy group. Service Facility Taxonomy - taxonomy of the facility Provider must be included in the taxonomy group. Procedure Category - procedure code on the service line must fall into the indicated procedure category. Procedure Cluster - procedure code on the service line must fall into the indicated procedure cluster. Provider Federal ID - federal ID of the claim's Provider."},"entry_Date":{"type":"string","description":"Date when the record was added to the system.","format":"date-time"},"entry_User":{"maxLength":20,"type":"string","description":"User that first added the record to the system.","nullable":true},"exclude":{"type":"boolean","description":"Indicates whether the specified code is included or excluded. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"extra_Value1":{"maxLength":128,"type":"string","description":"Additional value that may be associated with the Benefit Level.","nullable":true},"extra_Value2":{"maxLength":128,"type":"string","description":"Additional value that may be associated with the Benefit Level.","nullable":true},"from_Value":{"maxLength":128,"type":"string","description":"Initial value in the range of values.","nullable":true},"plan_ID":{"maxLength":20,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References the PlanBenefits.Plan_ID value in parent table."},"children":[]}]}]}],"nullable":true},"thru_Value":{"maxLength":128,"type":"string","description":"Final value in the range of values.","nullable":true},"update_Date":{"type":"string","description":"Date when the record was last updated in the system.","format":"date-time"},"update_User":{"maxLength":20,"type":"string","description":"User that last updated the record in the system.","nullable":true},"value_Type":{"maxLength":32,"type":"string","description":"Specifies the type or measure of the associated Benefit Level values.","nullable":true}},"additionalProperties":false}},"components/schemas/PlanBenefitLevelListVBAResponse":{"id":"components/schemas/PlanBenefitLevelListVBAResponse","kind":"json-schema","title":"PlanBenefitLevelListVBAResponse","data":{"type":"object","properties":{"data":{"type":"array","items":{"$ref":"#/components/schemas/PlanBenefitLevel"},"nullable":true},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/PlanBenefitLevelVBAResponse":{"id":"components/schemas/PlanBenefitLevelVBAResponse","kind":"json-schema","title":"PlanBenefitLevelVBAResponse","data":{"type":"object","properties":{"data":{"$ref":"#/components/schemas/PlanBenefitLevel"},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/PlanBenefitPBM":{"id":"components/schemas/PlanBenefitPBM","kind":"json-schema","title":"PlanBenefitPBM","data":{"required":["benefit_Code","pbM_Type","plan_ID"],"type":"object","properties":{"plan_ID":{"maxLength":20,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References the PlanBenefits.Plan_ID value in parent table."},"children":[]}]}]}]},"benefit_Code":{"maxLength":10,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References the PlanBenefits.Benefit_Code value in parent table."},"children":[]}]}]}]},"pbM_Type":{"maxLength":8,"minLength":1,"type":"string","description":"User-defined type of pharmacy benefit copay. This information is pulled into the Member SPD matrix on the Member screen."},"co_Pay_Amount":{"type":"number","description":"Amount of Copay that the Member is responsible for.","format":"double","nullable":true}},"additionalProperties":false}},"components/schemas/PlanBenefitPBMListVBAResponse":{"id":"components/schemas/PlanBenefitPBMListVBAResponse","kind":"json-schema","title":"PlanBenefitPBMListVBAResponse","data":{"type":"object","properties":{"data":{"type":"array","items":{"$ref":"#/components/schemas/PlanBenefitPBM"},"nullable":true},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/PlanBenefitPBMVBAResponse":{"id":"components/schemas/PlanBenefitPBMVBAResponse","kind":"json-schema","title":"PlanBenefitPBMVBAResponse","data":{"type":"object","properties":{"data":{"$ref":"#/components/schemas/PlanBenefitPBM"},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/PlanBenefitRate":{"id":"components/schemas/PlanBenefitRate","kind":"json-schema","title":"PlanBenefitRate","data":{"required":["benefit_Code","effective_Date","plan_ID","planBenefitRate_Key","rate","rate_Pct","rate_Type"],"type":"object","properties":{"planBenefitRate_Key":{"type":"integer","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Unique idenfiter assigned to the Plan Benefit Rate.  Note: The database will apply a default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"0"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" for this field if a value is not provided.  This field is also marked as NOT NULL in the database and therefore required by the API.  If you do not have a value for this field, supply the database default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"0"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" to meet the API requirements and ensure that the functionality occurs as expected."},"children":[]}]}]}],"format":"int32"},"benefit_Code":{"maxLength":10,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References the PlanBenefits.Benefit_Code value in parent table."},"children":[]}]}]}]},"effective_Date":{"type":"string","description":"Date when the Rate becomes effective.","format":"date-time"},"entry_Date":{"type":"string","description":"Date when the record was added to the system.","format":"date-time"},"entry_User":{"maxLength":20,"type":"string","description":"User that first added the record to the system.","nullable":true},"ex_Code":{"maxLength":6,"type":"string","description":"This code is applied to any claim that utilizes the benefit rate.","nullable":true},"network_ID":{"maxLength":10,"type":"string","description":"Network ID associated with the Plan Benefit Rate","nullable":true},"plan_ID":{"maxLength":20,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References the PlanBenefits.Plan_ID value in parent table."},"children":[]}]}]}]},"rate":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"This area will allow for a limit (dollar or percentage) of how much of the allowed amount can be paid out, per claim detail line, by the specific plan benefit.  Note: The database will apply a default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"0"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" for this field if a value is not provided.  This field is also marked as NOT NULL in the database and therefore required by the API.  If you do not have a value for this field, supply the database default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"0"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" to meet the API requirements and ensure that the functionality occurs as expected."},"children":[]}]}]}],"format":"double"},"rate_Max":{"type":"number","description":"Max rate that can be paid out.","format":"double","nullable":true},"rate_Max_Type":{"maxLength":6,"type":"string","description":"Type of Benefit Level Maximum: Per Calendar Year - January 1st through December 31st. Per Plan Year - per plan year as defined by the Group.","nullable":true},"rate_Pct":{"type":"boolean","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Indicates whether the Rate will be a percentage or fixed amount.  Note: The database will apply a default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"False"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" for this field if a value is not provided.  This field is also marked as NOT NULL in the database and therefore required by the API.  If you do not have a value for this field, supply the database default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"False"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" to meet the API requirements and ensure that the functionality occurs as expected."},"children":[]}]}]}]},"rate_Type":{"maxLength":6,"minLength":1,"type":"string","description":"Type of Benefit Rate: Per Service Line - rate is applied to each service line. Per Day - rate is applied per service date. Per Visit - rate is applied per service date per Provider. Per Unit - rate is multiplied by the number of units on the matching service line."},"term_Date":{"type":"string","description":"Date when the Rate expires.","format":"date-time","nullable":true},"update_Date":{"type":"string","description":"Date when the record was last updated in the system.","format":"date-time"},"update_User":{"maxLength":20,"type":"string","description":"User that last updated the record in the system.","nullable":true}},"additionalProperties":false}},"components/schemas/PlanBenefitRateListVBAResponse":{"id":"components/schemas/PlanBenefitRateListVBAResponse","kind":"json-schema","title":"PlanBenefitRateListVBAResponse","data":{"type":"object","properties":{"data":{"type":"array","items":{"$ref":"#/components/schemas/PlanBenefitRate"},"nullable":true},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/PlanBenefitRateVBAResponse":{"id":"components/schemas/PlanBenefitRateVBAResponse","kind":"json-schema","title":"PlanBenefitRateVBAResponse","data":{"type":"object","properties":{"data":{"$ref":"#/components/schemas/PlanBenefitRate"},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/PlanBenefits":{"id":"components/schemas/PlanBenefits","kind":"json-schema","title":"PlanBenefits","data":{"required":["always_Pay_In_Network","benefit_Code","coIns_In_To_Out","coIns_Out_To_In","coIns_Out_To_In_Limit","coverage_24Hour","covered","ded_In_To_Out","ded_Out_To_In","ded_Out_To_In_Limit","deductible_Before_CoPay","excluded","hospital_1stDay","ltC_Applies_To_Elimination_Period","ltC_Applies_To_WP","ltC_Apply_Inflation","ltC_Base_Benefit","ltC_Inflation_Benefit","ltC_Inflation_Compound","ltC_Shared_Benefit","ltC_Use_Benefit_DBA","ltC_Use_Benefit_Lifetime_Max","ltC_Use_Benefit_MBA","ltC_Use_Pct_Of_Benefit","maternity","occupational","ooP_In_To_Out","ooP_Out_To_In","ooP_Out_To_In_Limit","parent_Benefit","pcP_Only","plan_ID","rider","use_Plan_CoIns","use_Plan_Ded","use_Plan_Max","use_Plan_OOP"],"type":"object","properties":{"plan_ID":{"maxLength":20,"minLength":1,"type":"string","description":"Unique identifier assigned to the Plan."},"benefit_Code":{"maxLength":10,"minLength":1,"type":"string","description":"Unique identifier assigned to the Benefit."},"accident_Only":{"maxLength":1,"type":"string","description":"Checking this option indicates that the benefit is covered only when services are rendered as the result of an accident. On the Claim Entry screen, there are options to that specify that a claim is the result of an accident. If a claim is processed against this Benefit Code without one of the accident options picked on the claim, the claim will automatically 'Deny' or 'Pend' based on the Ex Code defined on the VBA Control Panel.","nullable":true},"always_Pay_In_Network":{"type":"boolean","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"When checked, if the PlanBenefit_Override_Network_ID is filled out on companydata and the claim is currently out of network, change the Network ID to the PlanBenefit Override Network ID  value. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"children":[]}]}]}]},"annual_Max":{"type":"number","description":"Total annual amount that the Plan will pay both In Network and Out of Network.","format":"double","nullable":true},"annual_Max_Member":{"type":"number","description":"Total annual amount that the Member pays both In Network and Out of Network.","format":"double","nullable":true},"annual_Max_Net":{"type":"number","description":"Annual amount that the Plan will pay In Network.","format":"double","nullable":true},"annual_Max_Net_Member":{"type":"number","description":"Annual amount that the Member pays In Network.","format":"double","nullable":true},"annual_Max_OON":{"type":"number","description":"Annual amount that the Plan will pay Out of Network.","format":"double","nullable":true},"annual_Max_OON_Member":{"type":"number","description":"Annual amount that the Member pays Out of Network.","format":"double","nullable":true},"coIns_In_To_Out":{"type":"boolean","description":"Applies the In-Network Co-Insurance amount toward the satisfaction of the Out-of-Network Co-Insurance maximum. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"coIns_Max_Mem":{"type":"number","description":"In Network Co-Insurance amount for the Family.","format":"double","nullable":true},"coIns_Max_Net_Mem":{"type":"number","description":"Total Co-Insurance amount for the Member.","format":"double","nullable":true},"coIns_Max_Net_Sub":{"type":"number","description":"Out of Network Co-Insurance amount for the Family.","format":"double","nullable":true},"coIns_Max_OON_Mem":{"type":"number","description":"Out of Network Co-Insurance amount for the Member.","format":"double","nullable":true},"coIns_Max_OON_Sub":{"type":"number","description":"In Network Co-Insurance amount for the Member.","format":"double","nullable":true},"coIns_Max_Sub":{"type":"number","description":"Maximum CoInsurance amount for the Family per plan year.","format":"double","nullable":true},"coIns_Out_To_In":{"type":"boolean","description":"Applies the Out-of-Network Co-Insurance amount toward the satisfaction of the In-Network Co-Insurance maximum. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"coIns_Out_To_In_Limit":{"type":"boolean","description":"When active, this will let the system know to limit the amount of co-insurance that applies to IN from OON by the Max. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"coIns_Out_To_In_Limit_Max":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"The max with which the co-insurance is limited by when CoIns_Out To In Limit is selected."},"children":[]}]}]}],"format":"double","nullable":true},"coverage_24Hour":{"type":"boolean","description":"This option is informational only. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"covered":{"maxLength":1,"minLength":1,"type":"string","description":"Identifies whether the Benefit Code is covered for this Plan. This can be populated from the 'Plan' screen. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"covered_In_Net_Only":{"maxLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Checking this option indicates that the Benefit is covered only when services are rendered by an In-Network provider. If a claim is processed against this Benefit Code as Out of Network, the claim will apply the “Covered In-Network Only“ Ex Code defined on the VBA Control Panel."},"children":[]}]}]}],"nullable":true},"ded_In_To_Out":{"type":"boolean","description":"Applies the In-Network deductible amount toward the satisfaction of the Out-of-Network deductible. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"ded_Out_To_In":{"type":"boolean","description":"Applies the Out-of-Network deductible amount toward the satisfaction of the In-Network deductible. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"ded_Out_To_In_Limit":{"type":"boolean","description":"When active, this will let the system know to limit the amount of deductible that applies to IN from OON by the Max. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"ded_Out_To_In_Limit_Max":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"The max with which the deducible is limited by when Ded_Out To In Limit is selected."},"children":[]}]}]}],"format":"double","nullable":true},"deductible_Before_CoPay":{"type":"boolean","description":"This flag determines if adjudication calculates the Deductible before the CoPay is calculated. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"effective_Date":{"type":"string","description":"Date when the Benefit becomes effective on this plan.","format":"date-time","nullable":true},"entry_Date":{"type":"string","description":"Date when the record was added to the system.","format":"date-time"},"entry_User":{"maxLength":20,"type":"string","description":"User that first added the record to the system.","nullable":true},"excluded":{"maxLength":1,"minLength":1,"type":"string","description":"Identifies whether the Benefit Code is excluded for this Plan. This can be populated from the 'Plan' screen. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"hospital_1stDay":{"type":"boolean","description":"This option is informational only. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"include_Amt_In_Plan":{"maxLength":1,"type":"string","description":"Indicates that the Plan Benefit amount is included in the Plan level Maximum calculations. If this option is not specified, the Benefit is treated as a carve-out and will calculate to its own total.","nullable":true},"include_CoIns_In_Plan":{"maxLength":1,"type":"string","description":"Indicates that the Plan Benefit amount is included in the Plan level Co-Insurance calculations. If this option is not specified, the Benefit is treated as a carve-out and will calculate to its own total.","nullable":true},"include_Ded_In_Plan":{"maxLength":1,"type":"string","description":"Indicates that the Plan Benefit amount is included in the Plan level Deductible calculations. If this option is not specified, the Benefit is treated as a carve-out and will calculate to its own total.","nullable":true},"include_OOP_In_Plan":{"maxLength":1,"type":"string","description":"Indicates that the Plan Benefit amount is included in the Plan level Out of Pocket calculations. If this option is not specified, the Benefit is treated as a carve-out and will calculate to its own total.","nullable":true},"ltC_Applies_To_Elimination_Period":{"type":"boolean","description":"Indicates if this benefits applies to the Elimination Period for claims processed under this plan.  This value would only apply if the Plan itself is configured with an Elimination Period.  This indicator will be ON by default so that the user has to specifically exclude. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"ltC_Applies_To_WP":{"type":"boolean","description":"Indicates if this benefit applies to the waiting period. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"ltC_Apply_Inflation":{"type":"boolean","description":"Indicates it Inflation calculation should be applied Note: This field is marked as NOT NULL in the database and therefore required by the API."},"ltC_Base_Benefit":{"type":"boolean","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Not sure about this, but I think what I want is to have one benefit defined on any plan that has a LTC Plan_Type.  You can only have one and must have one.  This is like the STD or LTD benefit on disability.  Its the benefit we use to do all the base benefit payment stuff. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"children":[]}]}]}]},"ltC_Daily_Benefit":{"type":"number","description":"This is the daily benefit amount","format":"double","nullable":true},"ltC_Daily_Benefit_Range_From":{"type":"number","description":"The start of the selection range for members taking this plan and choosing their daily benefit.","format":"double","nullable":true},"ltC_Daily_Benefit_Range_Increment":{"type":"number","description":"The increment of each option in the range between the from and thru.  If empty, the member can manually select a value between the from / thru range.","format":"double","nullable":true},"ltC_Daily_Benefit_Range_Thru":{"type":"number","description":"The end of the selection range for members taking this plan and choosing their daily benefit.","format":"double","nullable":true},"ltC_Daily_Benefit_Type":{"maxLength":32,"type":"string","description":"This is the type of daily benefit defined for this plan.  The values are:  A - a flat daily benefit enforced by the plan.  B - member selected value utilizing the daily benefit range/increment settings.","nullable":true},"ltC_Inflation_Benefit":{"type":"boolean","description":"identify that this is an inflation benefit.  Would still use Covered/Rider to determine if the inflation offering is optional or not. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"ltC_Inflation_Compound":{"type":"boolean","description":"Indicates if the inflation interest is simple (0) or compunded (1). Note: This field is marked as NOT NULL in the database and therefore required by the API."},"ltC_Inflation_Frequency":{"type":"integer","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"this is the value for the Inflation_Frequency_Type (i.e. 1 Year, 30 Days, 6 Months, etc.)"},"children":[]}]}]}],"format":"int32","nullable":true},"ltC_Inflation_Frequency_Start":{"maxLength":32,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"indicates when the Inflation_Frequency is calculated from:  GROUP - Group Anniversary Enroll  DIV - Division Anniversary Enroll  MEMBER - Member Anniversary Enroll  PLAN - Initial Plan Enroll"},"children":[]}]}]}],"nullable":true},"ltC_Inflation_Frequency_Type":{"maxLength":32,"type":"string","description":"Indicates the frequency of inflation increases.  The values are:  D - Days  M - Months  Y - Years","nullable":true},"ltC_Inflation_Limit":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"This value is based on Inflation_Limit_Type.  For A, this is the flat cap on inflation.  For B, this is the multiple of Limit defined as a cap (i.e. 2 for 2x limit or 2.5 for 2.5x limit)"},"children":[]}]}]}],"format":"double","nullable":true},"ltC_Inflation_Limit_Type":{"maxLength":32,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"the type of limit cap.  This filed only shows if Inflation_Type = B.  The 2 options are:  A - Flat Cap  B - Multipl of Limit"},"children":[]}]}]}],"nullable":true},"ltC_Inflation_Pct":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"This is the inflation value (i.e. 5% or 6%)"},"children":[]}]}]}],"format":"double","nullable":true},"ltC_Inflation_Type":{"maxLength":32,"type":"string","description":"drop down list of inflation types that change options that can be filled in.  The choices would be:  A - Simple Inflation  B - Inflation With Cap  C - Inflation No Cap","nullable":true},"ltC_Lifetime_Max_Days_From":{"type":"integer","description":"The selectable range of days the member can pick for calculations based on days.","format":"int32","nullable":true},"ltC_Lifetime_Max_Days_Thru":{"type":"integer","description":"The selectable range of days the member can pick for calculations based on days.","format":"int32","nullable":true},"ltC_Lifetime_Max_From":{"type":"number","description":"The low end range for member lifetime max selection.","format":"double","nullable":true},"ltC_Lifetime_Max_Increment":{"type":"number","description":"the increment of options the user can select within the max range.  Empty value here means it is a free from entry of max between the range.","format":"double","nullable":true},"ltC_Lifetime_Max_Thru":{"type":"number","description":"the high end range for member lifetime max selection.","format":"double","nullable":true},"ltC_Lifetime_Max_Type":{"maxLength":32,"type":"string","description":"Lifetime Max calculation type and will dicatate the max rules applied.  Valid values are:  STANDARD - DBM x 365 days x Lifetime Max Years selected  LMDAYS - DBM x Lifetime Max Days selected  FLAT - Lifetime Max Amount selected and not based on calculation  LMMONTHS - MBA x 12 Months x Lifetime Max Years selected","nullable":true},"ltC_Lifetime_Max_Years_From":{"type":"integer","description":"the selectable range of years the member can pick for calculations based on years.","format":"int32","nullable":true},"ltC_Lifetime_Max_Years_Thru":{"type":"integer","description":"the selectable range of years the member can pick for calculations based on years.","format":"int32","nullable":true},"ltC_Monthly_Benefit":{"type":"number","description":"This is the monthly benefit amount","format":"double","nullable":true},"ltC_Monthly_Benefit_Range_From":{"type":"number","description":"The start of the selection range for members taking this plan and choosing their monthly benefit.","format":"double","nullable":true},"ltC_Monthly_Benefit_Range_Increment":{"type":"number","description":"The increment of each option in the range between the from and thru.  If empty, the member can manually select a value between the from / thru range.","format":"double","nullable":true},"ltC_Monthly_Benefit_Range_Thru":{"type":"number","description":"The end of the selection range for members taking this plan and choosing their monthly benefit.","format":"double","nullable":true},"ltC_Monthly_Benefit_Type":{"maxLength":32,"type":"string","description":"This is the type of monthly benefit defined for this plan.  The values are:  A - a flat monthly benefit enforced by the plan.  B - member selected value utilizing the monthly benefit range/increment settings.","nullable":true},"ltC_Pct_Of_Benefit":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"the pct the be calculated against the pct_of_benefit_code."},"children":[]}]}]}],"format":"double","nullable":true},"ltC_Pct_Of_Benefit_Code":{"maxLength":10,"type":"string","description":"This is the benefit code that this benefit will be a Pct of.","nullable":true},"ltC_Shared_Benefit":{"type":"boolean","description":"Indicates if this Benefit Code is shared across multiple members of the family AND can be used in Lifetime Max calculations to determine if the same benefit across multiple plans (same plan type) could apply together. 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Note: This field is marked as NOT NULL in the database and therefore required by the API."},"procedureAgeKey":{"type":"integer","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References the PlanProcedureAge.PlanProcedureAge_Key value in parent table. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"children":[]}]}]}],"format":"int32"},"update_Date":{"type":"string","description":"Date when the record was last updated in the system.","format":"date-time"},"update_User":{"maxLength":20,"type":"string","description":"User that last updated the record in the system.","nullable":true}},"additionalProperties":false}},"components/schemas/PlanProcedureAgeModifierListVBAResponse":{"id":"components/schemas/PlanProcedureAgeModifierListVBAResponse","kind":"json-schema","title":"PlanProcedureAgeModifierListVBAResponse","data":{"type":"object","properties":{"data":{"type":"array","items":{"$ref":"#/components/schemas/PlanProcedureAgeModifier"},"nullable":true},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/PlanProcedureAgeModifierVBAResponse":{"id":"components/schemas/PlanProcedureAgeModifierVBAResponse","kind":"json-schema","title":"PlanProcedureAgeModifierVBAResponse","data":{"type":"object","properties":{"data":{"$ref":"#/components/schemas/PlanProcedureAgeModifier"},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/PlanProcedureAgeVBAResponse":{"id":"components/schemas/PlanProcedureAgeVBAResponse","kind":"json-schema","title":"PlanProcedureAgeVBAResponse","data":{"type":"object","properties":{"data":{"$ref":"#/components/schemas/PlanProcedureAge"},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/PlanRelationshipAge":{"id":"components/schemas/PlanRelationshipAge","kind":"json-schema","title":"PlanRelationshipAge","data":{"required":["ex_Code","from_Age","plan_ID","planRelationshipAge_Key","relate_Code","thru_Age"],"type":"object","properties":{"planRelationshipAge_Key":{"type":"integer","description":"Unique identifier for each Relationship Age rule. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"int32"},"age_Type":{"maxLength":16,"type":"string","description":"Birth Date' or 'End of Birth Month'","nullable":true},"entry_Date":{"type":"string","description":"Date when the record was added to the system.","format":"date-time"},"entry_User":{"maxLength":20,"type":"string","description":"User that first added the record to the system.","nullable":true},"ex_Code":{"maxLength":6,"minLength":1,"type":"string","description":"Ex Code associated with the age restriction. The selected Ex Code will apply to ages outside of the defined range."},"from_Age":{"type":"integer","description":"Beginning of the range of acceptable ages. The selected Ex Code will apply to ages outside of the defined range. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"int32"},"plan_ID":{"maxLength":20,"minLength":1,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"References the Plans.Plan_ID value in parent table."},"children":[]}]}]}]},"relate_Code":{"maxLength":8,"minLength":1,"type":"string","description":"Code that identifies the relationship associated with the age restriction."},"thru_Age":{"type":"integer","description":"Ending of the range of acceptable ages. The selected Ex Code will apply to ages outside of the defined range. Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"int32"},"update_Date":{"type":"string","description":"Date when the record was last updated in the system.","format":"date-time"},"update_User":{"maxLength":20,"type":"string","description":"User that last updated the record in the system.","nullable":true}},"additionalProperties":false}},"components/schemas/PlanRelationshipAgeListVBAResponse":{"id":"components/schemas/PlanRelationshipAgeListVBAResponse","kind":"json-schema","title":"PlanRelationshipAgeListVBAResponse","data":{"type":"object","properties":{"data":{"type":"array","items":{"$ref":"#/components/schemas/PlanRelationshipAge"},"nullable":true},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/PlanRelationshipAgeVBAResponse":{"id":"components/schemas/PlanRelationshipAgeVBAResponse","kind":"json-schema","title":"PlanRelationshipAgeVBAResponse","data":{"type":"object","properties":{"data":{"$ref":"#/components/schemas/PlanRelationshipAge"},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/PlanType":{"id":"components/schemas/PlanType","kind":"json-schema","title":"PlanType","data":{"required":["capitated","claims","dental","disc_Fee","discountCard","encounters","hra","hsa","indemnity","lifeADD","ltc","ltd","medical","misc","pay_As_You_Go","pension","pharmacy","plan_Type","print_On_ID","section125","std","tier_Required","vision"],"type":"object","properties":{"plan_Type":{"maxLength":6,"minLength":1,"type":"string","description":"Unique identifier for each plan type that Identifies the Type of Plan (medical, dental, etc.)."},"capitated":{"type":"boolean","description":"Indicates whether the associated plan should be capitated. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"claims":{"type":"boolean","description":"No longer in use. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"dental":{"type":"boolean","description":"Indicates whether the specified plan type is a Dental Plan. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"description":{"maxLength":50,"type":"string","description":"A description area used to provider more detail about the plan type.","nullable":true},"disc_Fee":{"type":"boolean","description":"Indicates whether the specified plan type is associated with a Discount Fee. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"discountCard":{"type":"boolean","description":"Indicates whether the specified plan type is a associated with a discount card. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"encounters":{"type":"boolean","description":"No longer in use. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"entry_Date":{"type":"string","description":"Date when the record was added to the system.","format":"date-time"},"entry_User":{"maxLength":20,"type":"string","description":"User that first added the record to the system.","nullable":true},"hipaA_Code":{"maxLength":8,"type":"string","description":"HIPAA Code associated with the specified plan type.","nullable":true},"hra":{"type":"boolean","description":"Indicates whether the specified plan type is a HRA Plan. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"hsa":{"type":"boolean","description":"Indicates whether the specified plan type is a HSA Plan. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"iD_Card_Description":{"maxLength":8,"type":"string","description":"Shortened description of the plan type that is used to print on ID cards.","nullable":true},"indemnity":{"type":"boolean","description":"Indicates whether the specified plan type is an Indemnity Plan. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"ltc":{"type":"boolean","description":"Indicates if this plan type is a LTC plan type. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"ltd":{"type":"boolean","description":"Indicates whether the specified plan type is a Long-Term Disability Plan. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"lifeADD":{"type":"boolean","description":"Indicates whether the specified plan type is a Life/ADD Plan. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"medical":{"type":"boolean","description":"Indicates whether the specified plan type is a Medical Plan. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"misc":{"type":"boolean","description":"Indicates if this plan type is a miscellaneous plan type."},"pay_As_You_Go":{"type":"boolean","description":"No longer in use. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"pension":{"type":"boolean","description":"Indicates if this plan type is a Pension plan type. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"pharmacy":{"type":"boolean","description":"Indicates whether the specified plan type is a Pharmacy Plan. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"print_On_ID":{"type":"boolean","description":"Indicates whether the specified plan type should be printed on ID cards. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"std":{"type":"boolean","description":"Indicates whether the specified plan type is a Short-Term Disability Plan. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"section125":{"type":"boolean","description":"Indicates whether the specified plan type is a Section 125 Plan. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"tier_Required":{"type":"boolean","description":"This flag indicates Tier is a required field when updating an enrollment Note: This field is marked as NOT NULL in the database and therefore required by the API."},"update_Date":{"type":"string","description":"Date when the record was last updated in the system.","format":"date-time"},"update_User":{"maxLength":20,"type":"string","description":"User that last updated the record in the system.","nullable":true},"vision":{"type":"boolean","description":"Indicates whether the specified plan type is a Vision Plan. Note: This field is marked as NOT NULL in the database and therefore required by the API."}},"additionalProperties":false}},"components/schemas/PlanTypeListVBAResponse":{"id":"components/schemas/PlanTypeListVBAResponse","kind":"json-schema","title":"PlanTypeListVBAResponse","data":{"type":"object","properties":{"data":{"type":"array","items":{"$ref":"#/components/schemas/PlanType"},"nullable":true},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/PlanTypeVBAResponse":{"id":"components/schemas/PlanTypeVBAResponse","kind":"json-schema","title":"PlanTypeVBAResponse","data":{"type":"object","properties":{"data":{"$ref":"#/components/schemas/PlanType"},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/Plans":{"id":"components/schemas/Plans","kind":"json-schema","title":"Plans","data":{"required":["auto_Create_Flex","capitated","coIns_In_To_Out","coIns_Out_To_In","coIns_Out_To_In_Limit","context4_PlanPriceNotGreaterBilledFg","ded_In_To_Out","ded_Out_To_In","ded_Out_To_In_Limit","family_Level_Co_Ins","family_Level_Ded","family_Level_OOP","flex_Advance_Fund","ltC_Apply_Elimination_Period","ltC_Apply_Waiver_Of_Premium","ltC_Elimination_Period_Per_Claim","ltC_Lifetime_Max_Joint_Policy","ooP_In_To_Out","ooP_Out_To_In","ooP_Out_To_In_Limit","plan_ID","remove_Member_Amount_Edit","use_COB_Savings","visium_Edit"],"type":"object","properties":{"plan_ID":{"maxLength":20,"minLength":1,"type":"string","description":"Unique identifier assigned to the Plan."},"annual_Max":{"type":"number","description":"Total In-Network and Out of Network annual maximum the plan will pay out for the Familiy.","format":"double","nullable":true},"annual_Max_Net":{"type":"number","description":"In-Network annual maximum that the plan will pay out for the Familiy.","format":"double","nullable":true},"annual_Max_OON":{"type":"number","description":"Out of Network annual maximum that the plan will pay out for the Familiy.","format":"double","nullable":true},"auto_Create_Flex":{"type":"boolean","description":"Indicates if this plan allows auto-creation of Flex claims based on Group level configuration for flex auto-creation. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"cobrA_Plan_Type_Desc":{"maxLength":20,"type":"string","description":"Used for custom reporting and information.","nullable":true},"coB_Savings_Max":{"type":"number","description":"Indicates the maximum amount that can be held in COB savings.","format":"double","nullable":true},"coB_Type":{"maxLength":16,"type":"string","description":"Indicates the type of COB to be used with the selected plan.","nullable":true},"capitated":{"type":"boolean","description":"No longer in use. All captiation logic and processing now resides in the capitation tables. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"cash_Value_Default":{"type":"integer","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Default cash value when Policy & Forfeiture is used in enrollment."},"children":[]}]}]}],"format":"int32","nullable":true},"coIns_In_To_Out":{"type":"boolean","description":"Indicates whether In-Network Coinsurance amounts apply toward the satisfaction of Out of Network amounts. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"coIns_Max_Mem":{"type":"number","description":"In Network Co-Insurance amount for the Family.","format":"double","nullable":true},"coIns_Max_Net_Mem":{"type":"number","description":"Total Co-Insurance amount for the Member.","format":"double","nullable":true},"coIns_Max_Net_Sub":{"type":"number","description":"Out of Network Co-Insurance amount for the Family.","format":"double","nullable":true},"coIns_Max_OON_Mem":{"type":"number","description":"Out of Network Co-Insurance amount for the Member.","format":"double","nullable":true},"coIns_Max_OON_Sub":{"type":"number","description":"In Network Co-Insurance amount for the Member.","format":"double","nullable":true},"coIns_Max_Sub":{"type":"number","description":"Total Co-Insurance amount for the Family.","format":"double","nullable":true},"coIns_Out_To_In":{"type":"boolean","description":"Indicates whether Out of Network CoInsurance amounts apply toward the satisfaction of the In-Network amounts. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"coIns_Out_To_In_Limit":{"type":"boolean","description":"When active, this will let the system know to limit the amount of co-insurance that applies to IN from OON by the Max. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"coIns_Out_To_In_Limit_Max":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"The max with which the co-insurance is limited by when CoIns_Out To In Limit is selected."},"children":[]}]}]}],"format":"double","nullable":true},"context4_ClmUcrPct":{"type":"integer","description":"Claim UCR percentage provided by Context. Required for Context claim edits and repricing.","format":"int32","nullable":true},"context4_ClmUcrPct_OON":{"type":"integer","description":"Out of network claim UCR percentage provided by context. Required for Context claim edits and repricing.","format":"int32","nullable":true},"context4_FeeSelector":{"maxLength":8,"type":"string","description":"Fee Selector provided by Context. Required for Context claim edits and repricing.","nullable":true},"context4_FeeSelector_OON":{"maxLength":8,"type":"string","description":"Out of network fee selector provided by context. Required for Context claim edits and repricing.","nullable":true},"context4_MedicarePct":{"type":"integer","description":"Medicare percentage provided by Context. Required for Context claim edits and repricing.","format":"int32","nullable":true},"context4_MedicarePct_OON":{"type":"integer","description":"Out of network Medicare percentage provided by context. Required for Context claim edits and repricing.","format":"int32","nullable":true},"context4_Password":{"maxLength":128,"type":"string","description":"Password provided by Context. Required for Context claim edits and repricing.","nullable":true},"context4_PayorType":{"maxLength":8,"type":"string","description":"Payor type provided by context. Required for Context claim edits and repricing.","nullable":true},"context4_PayorType_OON":{"maxLength":8,"type":"string","description":"Out of network Payor type provided by context. Required for Context claim edits and repricing.","nullable":true},"context4_PctOfChg":{"type":"integer","description":"Percentage of change provided by context. Required for Context claim edits and repricing.","format":"int32","nullable":true},"context4_PctOfChg_OON":{"type":"integer","description":"Out of network percentage of change provided by context. Required for Context claim edits and repricing.","format":"int32","nullable":true},"context4_PlanPriceNotGreaterBilledFg":{"type":"boolean","description":"When using Context4, the Plan Price is never allowed to exceed the Billed Price, it'll set it to the Billed Price. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"context4_UserID":{"maxLength":128,"type":"string","description":"User ID provided by Context. Required for Context claim edits and repricing.","nullable":true},"context4_WebURI":{"maxLength":256,"type":"string","description":"URL provided by Context. Required for Context claim edits and repricing.","nullable":true},"context4_WebURI_Delete":{"maxLength":256,"type":"string","description":"URL delete provided by Context. Required for Context claim edits and repricing.","nullable":true},"currency_ID":{"maxLength":16,"type":"string","description":"Indicates the currency being used.","nullable":true},"ded_In_To_Out":{"type":"boolean","description":"Indicates whether In-Network Deductible amounts apply toward the satisfaction of Out of Network amounts. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"ded_Out_To_In":{"type":"boolean","description":"Indicates whether Out of Network Deductible amounts apply toward the satisfaction of In-Network amounts. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"ded_Out_To_In_Limit":{"type":"boolean","description":"When active, this will let the system know to limit the amount of deductible that applies to IN from OON by the Max. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"ded_Out_To_In_Limit_Max":{"type":"number","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"The max with which the deducible is limited by when Ded_Out To In Limit is selected."},"children":[]}]}]}],"format":"double","nullable":true},"description":{"maxLength":50,"type":"string","description":"A short description of the associated plan.","nullable":true},"entry_Date":{"type":"string","description":"Date when the record was added to the system.","format":"date-time"},"entry_User":{"maxLength":20,"type":"string","description":"User that first added the record to the system.","nullable":true},"extended_Term_Default":{"type":"integer","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Deault extended term value assigned in Policy & Forfeiture when used in enrollment."},"children":[]}]}]}],"format":"int32","nullable":true},"family_Level_Co_Ins":{"type":"boolean","description":"Specifies that the number of Member level Coinsurance amounts should be used to satisfy the Family level Coinsurance amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"family_Level_Co_Ins_Member":{"type":"integer","description":"Number of Members that must satisfy the Member level deductible before the Family level amount is considered met.","format":"int32","nullable":true},"family_Level_Ded":{"type":"boolean","description":"Specifies that the number of Member level deductible amounts should be used to satisfy the Family level deductible. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"family_Level_Ded_Member":{"type":"integer","description":"Number of Members that must satisfy the Member level deductible before the Family level amount is considered met.","format":"int32","nullable":true},"family_Level_OOP":{"type":"boolean","description":"Specifies that the number of Member level Out of Pocket amounts should be used to satisfy the Family level Out of Pocket amount. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"family_Level_OOP_Member":{"type":"integer","description":"Number of Members that must satisfy the Member level Out of Pocket before the Family level Out of Pocket is considered met.","format":"int32","nullable":true},"flex_Advance_Fund":{"type":"boolean","description":"Information field used in reporting to identify this plan as Flex Advance Fund. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"flex_Type":{"maxLength":16,"type":"string","description":"Indicates what type of Flex account to be associated with the plan.","nullable":true},"forfeiture_Status_Default":{"maxLength":32,"type":"string","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Default forfeiture status assigned when Policy & Forteiture is used in enrollment."},"children":[]}]}]}],"nullable":true},"illness_Ex_Code":{"maxLength":8,"type":"string","description":"Ex Code associated with the illness waiting period.","nullable":true},"illness_Waiting_Period":{"type":"integer","description":"Waiting Period after an illness for Disability plans to start coverage.","format":"int32","nullable":true},"include_Waiting_Period":{"type":"boolean","description":"Indicates whether the Disability plan includes a waiting period.","nullable":true},"injury_Ex_Code":{"maxLength":8,"type":"string","description":"Ex Code associated with the injury waiting period.","nullable":true},"injury_Waiting_Period":{"type":"integer","description":"Waiting Period after an injury for Disability plans to start coverage.","format":"int32","nullable":true},"ltC_Apply_Elimination_Period":{"type":"boolean","description":"Indicates if this Plan has Elimination Period rules. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"ltC_Apply_Waiver_Of_Premium":{"type":"boolean","description":"Indicates if Waiver of Premium rules should apply for this plan. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"ltC_Daily_Benefit":{"type":"number","description":"This is the daily benefit amount","format":"double","nullable":true},"ltC_Daily_Benefit_Range_From":{"type":"number","description":"The start of the selection range for members taking this plan and choosing their daily benefit.","format":"double","nullable":true},"ltC_Daily_Benefit_Range_Increment":{"type":"number","description":"The increment of each option in the range between the from and thru.  If empty, the member can manually select a value between the from / thru range.","format":"double","nullable":true},"ltC_Daily_Benefit_Range_Thru":{"type":"number","description":"The end of the selection range for members taking this plan and choosing their daily benefit.","format":"double","nullable":true},"ltC_Daily_Benefit_Type":{"maxLength":32,"type":"string","description":"This is the type of daily benefit defined for this plan.  The values are:  A - a flat daily benefit enforced by the plan.  B - member selected value utilizing the daily benefit range/increment settings.","nullable":true},"ltC_Elimination_Period":{"type":"integer","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"This is the elimination period value based on Elimination_Period_Type."},"children":[]}]}]}],"format":"int32","nullable":true},"ltC_Elimination_Period_Per_Claim":{"type":"boolean","description":"Indicates if the elimination period is per claim.  By default the elimination period is per plan/policy. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"ltC_Elimination_Period_Type":{"maxLength":32,"type":"string","description":"This is the type of Elimination Period rule to apply for this Plan.  Values are:  A - Calendar Days  B - Service Days  C - Special Service Days (one day equals a week of elimination period)","nullable":true},"ltC_Lifetime_Max_Days_From":{"type":"integer","description":"The selectable range of days the member can pick for calculations based on days.","format":"int32","nullable":true},"ltC_Lifetime_Max_Days_Thru":{"type":"integer","description":"The selectable range of days the member can pick for calculations based on days.","format":"int32","nullable":true},"ltC_Lifetime_Max_From":{"type":"number","description":"The low end range for member lifetime max selection.","format":"double","nullable":true},"ltC_Lifetime_Max_Increment":{"type":"number","description":"The increment of options the user can select within the max range.  Empty value here means it is a free from entry of max between the range.","format":"double","nullable":true},"ltC_Lifetime_Max_Joint_Policy":{"type":"boolean","description":"Indicates if plans of the same plan type, and both flagged as joint policy, can share a \"Total\" lifetime max between both plans as long as both plans have selected a shared benefit. Note: This field is marked as NOT NULL in the database and therefore required by the API."},"ltC_Lifetime_Max_Thru":{"type":"number","description":"The high end range for member lifetime max selection.","format":"double","nullable":true},"ltC_Lifetime_Max_Type":{"maxLength":32,"type":"string","description":"Lifetime Max calculation type and will dicatate the max rules applied.  Valid values are:  STANDARD - DBM x 365 days x Lifetime Max Years selected  LMDAYS - DBM x Lifetime Max Days selected  FLAT - Lifetime Max Amount selected and not based on calculation  LMMONTHS - MBA x 12 Months x Lifetime Max Years selected","nullable":true},"ltC_Lifetime_Max_Years_From":{"type":"integer","description":"the selectable range of years the member can pick for calculations based on years.","format":"int32","nullable":true},"ltC_Lifetime_Max_Years_Thru":{"type":"integer","description":"The selectable range of years the member can pick for calculations based on years.","format":"int32","nullable":true},"ltC_Monthly_Benefit":{"type":"number","description":"This is the monthly benefit amount","format":"double","nullable":true},"ltC_Monthly_Benefit_Range_From":{"type":"number","description":"The start of the selection range for members taking this plan and choosing their monthly benefit.","format":"double","nullable":true},"ltC_Monthly_Benefit_Range_Increment":{"type":"number","description":"The increment of each option in the range between the from and thru.  If empty, the member can manually select a value between the from / thru range.","format":"double","nullable":true},"ltC_Monthly_Benefit_Range_Thru":{"type":"number","description":"The end of the selection range for members taking this plan and choosing their monthly benefit.","format":"double","nullable":true},"ltC_Monthly_Benefit_Type":{"maxLength":32,"type":"string","description":"This is the type of monthly benefit defined for this plan.  The values are:  A - a flat monthly benefit enforced by the plan.  B - member selected value utilizing the monthly benefit range/increment settings.","nullable":true},"ltC_Waiver_Of_Premium_Type":{"maxLength":32,"type":"string","description":"This is the type/rules for LTC waiver of premium. 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Note: This field is marked as NOT NULL in the database and therefore required by the API."},"visium_Setting_ID":{"maxLength":32,"type":"string","description":"This field is not currently used - future-proofing for additional custom parameters","nullable":true},"talon_Edit":{"type":"boolean"},"talon_Criteria_Key":{"type":"integer","format":"int32","nullable":true},"clearity_Plan":{"type":"boolean"},"clearity_Criteria_Key":{"type":"integer","format":"int32","nullable":true},"multi_Tier_Plan":{"type":"boolean"},"in_Network_Tier_Name":{"type":"string","nullable":true},"out_Of_Network_Tier_Name":{"type":"string","nullable":true}},"additionalProperties":false}},"components/schemas/PlansListVBAResponse":{"id":"components/schemas/PlansListVBAResponse","kind":"json-schema","title":"PlansListVBAResponse","data":{"type":"object","properties":{"data":{"type":"array","items":{"$ref":"#/components/schemas/Plans"},"nullable":true},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/PlansVBAResponse":{"id":"components/schemas/PlansVBAResponse","kind":"json-schema","title":"PlansVBAResponse","data":{"type":"object","properties":{"data":{"$ref":"#/components/schemas/Plans"},"error":{"$ref":"#/components/schemas/VBAProblemDetails"},"debug":{"$ref":"#/components/schemas/Debug"}},"additionalProperties":false}},"components/schemas/PolicyForfeitureExt":{"id":"components/schemas/PolicyForfeitureExt","kind":"json-schema","title":"PolicyForfeitureExt","data":{"required":["policyForfeitureExt_Key"],"type":"object","properties":{"policyForfeitureExt_Key":{"type":"integer","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"Key value identifying a policy forfeiture extension  Note: The database will apply a default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"0"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" for this field if a value is not provided.  This field is also marked as NOT NULL in the database and therefore required by the API.  If you do not have a value for this field, supply the database default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"0"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" to meet the API requirements and ensure that the functionality occurs as expected."},"children":[]}]}]}],"format":"int32"},"description":{"maxLength":512,"type":"string","description":"Description of a policy forfeiture extension","nullable":true},"entry_Date":{"type":"string","description":"Date record was first added to the system","format":"date-time"},"entry_User":{"maxLength":20,"type":"string","description":"User that first added the record to the system","nullable":true},"update_Date":{"type":"string","description":"Date the record was last updated in the system","format":"date-time"},"update_User":{"maxLength":20,"type":"string","description":"User that last updated the record in the 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If you do not have a value for this field, supply the database default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"False"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" to meet the API requirements and ensure that the functionality occurs as expected."},"children":[]}]}]}]},"specialties":{"maxLength":50,"type":"string","description":"Specialty/Specialties of the individual Provider/entity.","nullable":true},"state":{"maxLength":10,"type":"string","description":"State of the rendering location.","nullable":true},"suffix":{"maxLength":20,"type":"string","description":"Suffix associated with the Provider.","nullable":true},"upiN_Number":{"maxLength":20,"type":"string","description":"This is an information field used for custom reporting.","nullable":true},"update_Date":{"type":"string","description":"Date when the record was last updated in the system.","format":"date-time"},"update_User":{"maxLength":20,"type":"string","description":"User that last updated the record in the system.","nullable":true},"use_Procedure_Code":{"type":"boolean","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"When this option is selected, adjudication will error any of this Provider's claims that contain revenue codes.  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If you do not have a value for this field, supply the database default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"False"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" to meet the API requirements and ensure that the functionality occurs as expected."},"children":[]}]}]}]},"use_Volume_Scale":{"type":"boolean","description":[{"$$mdtype":"Node","type":"paragraph","attributes":{},"children":[{"$$mdtype":"Node","type":"inline","attributes":{},"children":[{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":"This option tells the system to calculate the 'Volume' using the Group volume rules. Checking this box will display an elipsis that when clicked will explain the volume calculation. Plan type must include the \"Life AD&D\" indicator.  Note: The database will apply a default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"False"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" for this field if a value is not provided.  This field is also marked as NOT NULL in the database and therefore required by the API.  If you do not have a value for this field, supply the database default value of "},"children":[]},{"$$mdtype":"Node","type":"code","inline":true,"attributes":{"content":"False"},"children":[]},{"$$mdtype":"Node","type":"text","inline":true,"attributes":{"content":" to meet the API requirements and ensure that the functionality occurs as expected."},"children":[]}]}]}]},"volume":{"type":"number","description":"The Member's 'Volume' within the selected Rider benefit on the enrollment. The Member Enrollment 'Volume' has no impact on 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primary key and identifier of the record Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"int32"},"acH_Pull_Day":{"type":"integer","description":"Day of the month the ACH payment will be taken from the account","format":"int32","nullable":true},"benefit_Code":{"maxLength":10,"type":"string","description":"References the benefit code associated with the payment method","nullable":true},"effective_Date":{"type":"string","description":"The effective date of the payment method Note: This field is marked as NOT NULL in the database and therefore required by the API.","format":"date-time"},"entry_Date":{"type":"string","description":"Date record was first added to the system","format":"date-time"},"entry_User":{"maxLength":20,"type":"string","description":"User that first added the record to the system","nullable":true},"payment_Method":{"maxLength":20,"minLength":1,"type":"string","description":"The payment method associated with the 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(YAML)","url":"/_bundle/openapi/vbasoftware/vbasoftware.api.yaml?download"}],"schemasExpansionLevel":0,"jsonSamplesExpandLevel":1,"hideSchemaTitles":true,"codeSamples":{"languages":[{"lang":"curl"},{"lang":"C#"},{"lang":"Python"},{"lang":"Node.js","label":"TypeScript"}]},"feedback":{"hide":true,"settings":{"label":""}},"mockServer":{"off":true},"disableRouter":true,"excludeFromSearch":false,"replayFeatures":{"graphql":false},"specType":"openapi","markdocOptions":{"tags":{},"nodes":{},"components":{}},"metadata":{"title":"VBASoftware API","description":"VBAPI is the REST API for reading and writing your organization's VBASoftware data: employer groups, subscribers and members, plans and benefits, providers, claims, authorizations, premium billing, and accounting. This reference lists all 5,340 operations on 2,946 paths, in the 31 groups shown in the sidebar.\n\nMost record types have list, get, create, update, delete, and batch operations. Advanced endpoints run VBASoftware business logic, such as adjudicating a claim queue; most of them are in the Advanced APIs group, under tags that start with `Adv.`.\n\n## Start here\n\n- **[Quick start](/developer-portal/get-started/quick-start):** log in and list five groups in about five minutes, in C#, Python, or TypeScript.\n- **[Credentials and environments](/developer-portal/get-started/credentials-and-environments):** the values VBA issues and which header each one goes in.\n- **[Authentication and tokens](/developer-portal/concepts/authentication):** log in once, reuse the ID token until it expires, and handle login challenges.\n- **[Playbooks](/developer-portal/playbooks):** end-to-end workflows with runnable code, such as onboarding an employer group or entering and adjudicating claims.\n- **[AI assistant and MCP server](/developer-portal/ai/overview):** ask the docs assistant, or connect your own AI tools to these docs.\n\n## Base URL and authentication\n\nClients use one host, the production API. Every call names the database it works in with the `vbasoftware-database` header. Because every call reaches production, write calls (`POST`, `PUT`, `DELETE`) change real records.\n\n```text\nhttps://vbapi.vbasoftware.com/vbasoftware\n```\n\nLog in with [`POST /user-authentication`](/openapi/vbasoftware/vbasoftware.api/user/userauthentication). It returns the tokens in `data.authenticationResult`; `expiresIn` is the ID token's lifetime in seconds.\n\n```http\nPOST /user-authentication\nx-api-key: <your API key>\nAuthorization: Basic <base64 of username:password>\nvbasoftware-client-id: <your client ID>\nvbasoftware-client-code: <your client code>\nvbasoftware-database: YOUR_DATABASE\n```\n\nEvery other call sends the ID token as a Bearer token:\n\n```http\nGET /groups?page=1&pageSize=5\nx-api-key: <your API key>\nAuthorization: Bearer <idToken>\nvbasoftware-database: YOUR_DATABASE\nUser-Agent: YourCompany-Integration/1.0\n```\n\n`User-Agent` is recommended, not required: a descriptive value lets VBA support find your calls in the logs.\n\n## Conventions\n\n- **Responses** use one envelope: `data`, `error`, and `debug.activityID`. Creates, gets, lists, and updates return `200` (not `201`), deletes return `204`, batch updates return `207`, and advanced operations that queue work return `202`. See [Requests and responses](/developer-portal/concepts/requests-and-responses).\n- **Lists** take `page` (pages start at 1) and `pageSize` (default 100), and return `TotalCount`, `TotalPages`, `CurrentPage`, and `PageSize` in the `X-Pagination` response header. Sort with `sortBy`, for example `group_ID:asc`. See [Pagination and sorting](/developer-portal/concepts/pagination-and-sorting).\n- **Errors** put a problem-details object in `error`; read `detail` first. Log the activity ID with every failure (error bodies spell it `debug.ActivityID`) and include it when you contact support. A missing or wrong `x-api-key` returns `403` with `{\"message\":\"Forbidden\"}` from the API gateway. See [Errors and troubleshooting](/developer-portal/concepts/errors).\n- **Rate limits** are 25 requests per second sustained, with bursts of up to 50, per API key. Everything that uses the same key shares the allowance, and a request over the limit returns `429`. See [Rate limits and performance](/developer-portal/concepts/rate-limits-and-performance).\n- **Search:** one [`POST /search`](/openapi/vbasoftware/vbasoftware.api/search-request/searchrequest) returns chosen columns from related tables, up to 750 rows a page. See [Search API](/developer-portal/concepts/search).\n\n## Functional areas\n\nOperation counts are per sidebar group. An operation with tags in more than one group is counted in each.\n\n**Business areas**\n\n| Area | What it covers | Operations |\n|---|---|--:|\n| [Group](/openapi/vbasoftware/vbasoftware.api/groups) | Employer groups, divisions, contracts and contract plans, plan years, group networks | 391 |\n| [Enrollment](/openapi/vbasoftware/vbasoftware.api/subscribers) | Subscribers, members, enrollments and enrollment plans, accumulators, ID card requests | 404 |\n| [Benefit](/openapi/vbasoftware/vbasoftware.api/plans) | Plans, plan benefits, benefit categories, plan accumulators and maximums | 361 |\n| [Claim](/openapi/vbasoftware/vbasoftware.api/claims) | Claims, claim batches, claim queues and adjudication, audits, claim invoices and payments | 587 |\n| [Auth](/openapi/vbasoftware/vbasoftware.api/auth) | Authorizations (not login): auth codes, diagnosis and procedure codes, reviews, work logs | 119 |\n| [Provider](/openapi/vbasoftware/vbasoftware.api/provider) | Providers, provider networks, rates, payees, per diems, taxonomy | 155 |\n| [Credentialing](/openapi/vbasoftware/vbasoftware.api/provider-credentialing) | Provider credentialing: licenses, certifications, attestations, contracts | 245 |\n| [FeeSchedule](/openapi/vbasoftware/vbasoftware.api/fee-schedules) | Fee schedules, schedule details, modifier and provider type discounts | 50 |\n| [Billing](/openapi/vbasoftware/vbasoftware.api/premium-invoices) | Premium invoices, payments, distributions, premium rates, past-due triggers | 276 |\n| [Accounting](/openapi/vbasoftware/vbasoftware.api/checks) | Checks and check batches, funding requests and deposits, reconciliations, payor accounts | 225 |\n| [Capitation](/openapi/vbasoftware/vbasoftware.api/capitations) | Capitations, capitation services and plan rates, adjustments, transactions | 74 |\n| [Commission](/openapi/vbasoftware/vbasoftware.api/commissions) | Commission agencies and reps, rates, activity, adjustments, transactions | 179 |\n| [Reinsurance](/openapi/vbasoftware/vbasoftware.api/reinsurance-contracts) | Reinsurance contracts, levels, criteria, transactions, accumulators | 162 |\n| [CareManagement](/openapi/vbasoftware/vbasoftware.api/care-cases) | Care cases, care plans, care managers and care units, intakes, treatments | 412 |\n| [Grievance](/openapi/vbasoftware/vbasoftware.api/grievances) | Grievances and their categories, issue, resolution, and status types | 44 |\n| [CallTracking](/openapi/vbasoftware/vbasoftware.api/call-trackings) | Call tracking records, call types, statuses, destinations | 47 |\n| [Note](/openapi/vbasoftware/vbasoftware.api/note-data) | Notes, note attachments, categories, references | 49 |\n| [Workflow](/openapi/vbasoftware/vbasoftware.api/workflows) | Workflows, workflow tasks and task users, workflow types | 48 |\n| [Report](/openapi/vbasoftware/vbasoftware.api/report-definitions) | Report definitions, report queues and schedules, report series, report tracking | 161 |\n\n**Platform and reference data**\n\n| Area | What it covers | Operations |\n|---|---|--:|\n| [Common](/openapi/vbasoftware/vbasoftware.api/diagnostic-codes) | Shared code and lookup tables: diagnostic and procedure codes, HIPAA codes, states and ZIP codes, networks, contacts, search configuration | 953 |\n| [Advanced APIs](/openapi/vbasoftware/vbasoftware.api/adv.-groups/groupdisenroll) | Business-logic operations under `Adv.` tags, such as claim refunds, premium invoice generation, and member or group disenrollment | 159 |\n| [Admin](/openapi/vbasoftware/vbasoftware.api/client-config) | Client configuration, company data, jobs, interface profiles, change data capture, IP allowlists | 167 |\n| [User](/openapi/vbasoftware/vbasoftware.api/user) | Login (`POST /user-authentication`), users and user groups, multi-factor authentication, password policy | 70 |\n| [Security](/openapi/vbasoftware/vbasoftware.api/security-areas) | Security areas, field security, user and user group access | 96 |\n| [Event](/openapi/vbasoftware/vbasoftware.api/events) | Events, event arguments, event schedules | 34 |\n| [VBAGateway](/openapi/vbasoftware/vbasoftware.api/vbagateway-subscription) | VBAGateway subscriptions and subscription details | 12 |\n| [VBAReporting](/openapi/vbasoftware/vbasoftware.api/vba-reports) | VBA reports | 8 |\n| [Support](/openapi/vbasoftware/vbasoftware.api/support) | Support operations | 5 |\n| [ProcessAutomation](/openapi/vbasoftware/vbasoftware.api/process-automation) | Process automation | 3 |\n| [Chat](/openapi/vbasoftware/vbasoftware.api/vbassist) | VBAssist | 2 |\n| [Interop](/openapi/vbasoftware/vbasoftware.api/baseload) | Base load | 1 |\n\n## Related\n\n- Generate a client library from this description: [Generate an SDK](/developer-portal/reference/generate-sdk).\n- Call operations from this reference without writing code: [Try it in the browser](/developer-portal/get-started/try-it).\n- Questions, or something does not work as documented: [Support and escalation](/developer-portal/help/support)."}},"baseSlug":"/openapi/vbasoftware/vbasoftware.api","routesMapping":{}}