Class steward is Patient Administration
A collection of health benefits.
A code serving as an additional refinement of an insurance plan. (e.g., standard, unified, maternity, . . .).
|IN1^31^00456^Type of Agreement Code|
An indication as to whether the insured agreed to assign the insurance benefits to the healthcare provider.
|IN1^20^00445^Assignment of Benefits|
An indication of the existence of baby coverage under the insurance plan.
|IN2^19^00490^Baby Coverage|
A description of the healthcare benefit.
An identifier for the healthcare coverage benefit plan.
|IN1^46^00471^Prior Insurance Plan ID|
The name of the benefit plan.
A code classifying the benefit plan type (e.g., commercial, Medicare, Medicaid, . . .).
|DRG^8^00770^DRG Payor| |IN1^15^00440^Plan Type|
An indication as to whether this insurance works in conjunction with other insurance plans, or if it provides independent coverage and payment of benefits regardless of other insurance that might be available to the patient.
|IN1^21^00446^Coordination of Benefits|
The deductible amount for blood.
|IN2^21^00492^Blood Deductible|
The priority sequence for an insurance plan that works in conjunction with other insurance.
|IN1^22^00447^Coord of Ben. Priority|
An indication as to whether charges for a baby should be combined with charges for the mother.
|IN2^20^00491^Combine Baby Bill|
An indication as to whether the patient has reached the copay limit.
|IN2^67^00807^Copay Limit Flag|
A code identifying the type of insurance coverage, or what type of services are covered for the purposes of a billing system.
The amount of the daily deductible for this insurance plan.
|IN2^30^00501^Daily Deductible|
The date the healthcare coverage first becomes effective.
|IN1^12^00437^Plan Effective Date|
A code depicting the source of information about the insured's eligibility for benefits (e.g., insurance company, employer, insured presented policy, insured presented card, signed statement on file, verbal information, none, . . .).
|IN2^27^00498^Eligibility Source|
The last date of service that the insurance will cover or be responsible for.
|IN1^13^00438^Plan Expiration Date|
A indication as to whether the healthcare coverage is a group contract.
A code indicating the party to which the claim should be mailed (e.g., employer, guarantor, insurance company, patient, . . .).
|IN2^5^00476^Mail Claim Party|
A code depicting the reason why a service is not covered.
|IN2^24^00495^Non-Covered Insurance Code|
An identifier of an healthcare benefit plan.
|IN1^35^00460^Company Plan Code|
The code classifying the amount (e.g. AT-Amount, PC-Percentage, LM-Limit)
Rationale: IN2-29
OpenIssue:
|IN2^29^00500^Policy Type/Amount|
The benefit limit amount or percentage.
Rationale: IN2-29
OpenIssue:
|IN2^29^00500^Policy Type/Amount|
The policy category code (e.g., ANC-ancillary, MMD-major medical)
Rationale: IN2-29
OpenIssue:
|IN2^29^00500^Policy Type/Amount|
The deductible amount specified by the insurance plan.
|IN1^37^00462^Policy Deductible|
The identifier for the healthcare coverage policy.
|IN1^36^00461^Policy Number|
The maximum number of days that the insurance policy will cover.
|IN1^39^00464^Policy Limit - Days|
A code depicting the extent of the coverage for a participating member (e.g., single, family, . . .).
|IN2^59^00799^Policy Scope |
A code indicating how the policy information was obtained.
|IN2^60^00800^Policy Source | |SCH^22^00800^Policy Source |
A code describing what information, if any, a provider can release about a patient.
|IN1^27^00452^Release Information Code|
The date a report of eligibility (ROE) was received.
Rationale: IN1-26
OpenIssue: should it be placed in Preauthorization.authorized_period_begin_dt instead? If so then Healthcare_benefit_plan.report_of_eligibility_ind should be moved to that class as well.
|IN1^26^00451^Rpt of Eligibility Date|
A indication of whether the insurance carrier send a report of eligibility identifying the benefits the patient is eligible for.
|IN1^25^00450^Rpt of Eligibility Flag|
A rate for a given room type.
|IN2^28^00499^Room Coverage Type/Amount|
A code depicting the status of the healthcare coverage.
|IN2^16^00487^Champus Status|
The date the healthcare coverage is no longer in effect.