MemberGroupPopulation
The table contains a list of member groups, which are used to identify member populations under different circumstances.
| Column Name | Type | Description |
|---|---|---|
| PhysicalDeploymentOwnerIdentifier | VARCHAR | ID of the physical deployment owner for this record. Physical owners will be where the data is hosted, either on the cross-over server or the owner deployment. |
| CapitationRiskRevenueProrationMethod | INTEGER | Proration method for capitation RR. |
| CapitationMemberLimitMaximumAge | INTEGER | Members exceeding this age will not be considered towards the member limit when computing capitation. |
| CapitationRiskRevenueMaximumRetroactiveDays | INTEGER | Specifies the capitation RR maximum retro days |
| MemberGroupName | VARCHAR | The name of the member group |
| MemberGroupAgeTestDay | INTEGER | Stores the member age test date to be used in the member group. |
| CapitationMaximumMembersPerCoverage | INTEGER | The maximum number of members per coverage that the member group pays capitation for each month. |
| MedicareAdvantageContractNumber | VARCHAR | Stores the contract number used in Medicare Advantage transactions. Used to determine the capitation contract premium billing account to post payments to when loading a MMR file. |
| NewAgeEffectiveNextMonthIndicator | VARCHAR | Stores Yes or No if the member's new age should take effect in the next capitation month. |
| MemberGroupComment | VARCHAR | Member group comment |
| PrimaryCareCapitationRetroactiveMonths | INTEGER | Default retro months for PCP Capitation. |
| PrimaryCareCapitationExplicitRetroactiveFlag | VARCHAR | Allows PCP transactions associated with the member group to be explicitly flagged for retro when dependencies have been updated. |
| WithholdCapitationForSuspendedMembersIndicator | VARCHAR | Indicates whether members in this member group should be withheld from outgoing capitation payments based on their premium billing delinquency status. 'Y' indicates that suspended members will not be capitated. 'N' indicates members will be capitated regardless of their suspension status. NULL indicates that the setting from the Tapestry profile will be used instead. |
| PrimaryCarePhysicianCapitationProrationMethod | INTEGER | Proration method for PCP capitation. |
| PrimaryCareProviderDefaultFactorType | INTEGER | Select the default rate factor type. If left blank, the benefit plan's default rate factor will be used. Category titles and abbreviations can be looked up from the ZC_RR_RATE_FACT_TYPE table. |
| MemberGroupAssociationExtensionIdentifier | NUMERIC | The unique identifier (.1) of the Association Extension used to determine which members are associated with a member group. |
| SpecialtyDefaultRateFactorType | INTEGER | Select the default rate factor type. If left blank, the benefit plan's default rate factor will be used. Category titles and abbreviations can be looked up from the ZC_RR_RATE_FACT_TYPE table. |
| InclusionRuleIdentifier | VARCHAR | The unique identifier (.1) of the Inclusion Rule members must pass to be included in the member group. |
| LogicalDeploymentOwnerIdentifier | VARCHAR | ID of the logical deployment owner for this record. Logical owners show the deployment where the record was created but doesn't represent if the record is a part of version skew. |
| MemberGroupEligibilityTestDate | INTEGER | The capitation test date of the member group |
| MemberGroupIdentification | VARCHAR | The unique ID of the member group |