Predictions are activated when the corresponding tables are present
Header fields
Column | Description | Data type |
|---|---|---|
Insured name | Full name of the person insured | string |
Insured NISZ | National insurance number of the person insured | string |
Insured Birthdate | Date of birth of the person insured | date |
Line items
detail_MUT
Table name: detail_MUT
Column | Description | Data type |
|---|---|---|
Date from | Date when the treatment period of the patient starts | date |
Date to | Date when the treatment period of the patient ends | date |
nomenclature code | Unique code of the service given | alphanumeric |
description | Description of the service given | string |
Number of units | Quantity of service units given | integer |
MUT amount | Amount refunded by the mutuality | float |
TK amount | Amount actually paid by the patient (includes both TTK, the regulated price and SUP, the surcharge on top of the regulated price) | float |
TTK amount | Amount charged by the caregiver (honorarium) in line with the convention/regulation | float |
PA amount | Amount to be paid by the patient (remgeld) | float |
SUP amount | Supplement, charge which is made on top of the regulated honorarium/prices (supplement) | float |
PA + SUP amount | Total amount of PA and SUP | float |
Subtotal line and Total line
Table names:
Subtotal line
Total line
Column | Description | Data type |
|---|---|---|
MUT amount | Total amount refunded by the mutuality | float |
TK amount | Total amount actually paid by the patient | float |
TTK amount | Total amount charged by the caregiver (honorarium) in line with the convention/regulation | float |
PA amount | Total amount to be paid by the patient | float |
SUP amount | Total supplement, charge made on top of regulated honorarium/prices (supplement) | float |
PA + SUP Amount | Total amount of PA and SUP | float |
Example
Consider the example below
Column mapping to field names
Total = MUT
Montant payé par l’affilié = TK
Honoraire = TTK
Quote-part personelle = PA
Supplément = SUP
In this case, the patient paid a visit to a certain care provider
The all-in price was 50€ (TK, “montant payé par l’affilié”), this consists of
The price in line with convention/regulation is 29.04€ (TTK, “Honoraire”), which consists of
The part paid for by the mutuality 17.04€ (MUT, “Total”)
The personal share of 12€ (PA, “Quote-part personnelle”)
The supplement of 20.96€ (SUP, “Supplément”)
In math terms
TK = TTK + SUP
TTK = MUT + PA