Claims Data Model
Entities and relationships involved in managing healthcare claims processing, including claim submission, adjudication, and payment workflows.
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Customizable Lucidchart Template
Business Account (Payer), Business Account (Purchaser), Business Account (Purchaser Group), Care PreAuth, Care PreAuth Item, Claim Diagnosis, Claim Diagnosis Procedure, Claim Header, Claim Line, Claim Provider, Coverage Benefit, Coverage Benefit Item, Healthcare Provider, Member Plan (Member Coverage), Person Account (Member), Plan Benefit, Plan Benefit Item, Purchaser Plan