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Medical Insurance Claim Process ER Diagram

The document outlines the objectives and outcomes of studying the medical insurance claims process, focusing on the identification of key entities such as Patient, Policy, Claim, and Approval. It details the attributes associated with each entity and their interrelationships, culminating in a structured Entity-Relationship diagram. Additionally, it provides rules for converting the ER model into a relational model and includes DDL queries for implementation.

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4 views4 pages

Medical Insurance Claim Process ER Diagram

The document outlines the objectives and outcomes of studying the medical insurance claims process, focusing on the identification of key entities such as Patient, Policy, Claim, and Approval. It details the attributes associated with each entity and their interrelationships, culminating in a structured Entity-Relationship diagram. Additionally, it provides rules for converting the ER model into a relational model and includes DDL queries for implementation.

Uploaded by

epardeshi62
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Title: Medical Insurance Claim

Objectives:

 To understand the process of medical insurance claims


 To identify key entities, their attributes, and the relationships among them in a database
system.
 To visually represent the structure of the data and its interconnections through an Entity-
Relationship diagram.

Outcomes:

 A well-structured ER diagram showing entities (Patient, Policy, Claim, Approval) and


their relationships.
 A list of relevant attributes for each entity.
 Better understanding of how data moves from patients to claims, linked through policies
and approvals.

Brief about the study:

Entities:

 Patient
 Policy
 Claim
 Approval
Attributes:

1) Patient:
 Name
 Address
 Contact No
 D.O.B (Date of Birth)
 Gender
2) Policy:
 Policy ID
 Type
 Premium
3) Claim:
 Claim ID
 Status
 Amount
 Reason
4) Approval:
 ID
 Amount
 Date
 Status

Relationships:

1) Patient Takes Policy:


 One patient can have multiple policies.
 Relationship: Takes

2) Patient Makes claims:


 One patient can take multiple claims.
 Relationship: Makes
3) Policy Covers Claims:
 Each claim must be related to a specific policy.
 Relationship: Covers

4) Claim Gets Approval:


 Each claim has exactly one approval.
 Relationship: Gets

ER Diagram:
Rules for converting ER Model to Relational Model:
Step 1: Convert each Entity to a Table.
Step 2: Convert Simple Relationships.
Step 3: Convert Attributes.
Step 4: Convert Weak Entities.
Step 5: Convert Specializations/Generalizations.

DDL Queries:

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