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CoverageBenefitItem

Specific service covered by the insurance plan. This object is available in API version 53.0 and later.

Supported Calls

create(), delete(), describeLayout(), describeSObjects(), getDeleted(), getUpdated(), query(), retrieve(), search(), undelete(), update(), upsert()

Fields

Field Details
BenefitCategory
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
Name of the category this benefit is in.
CodeSetServiceTypeId
Type
reference
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
ID of a Code Set Service Type in the Code Set object.
This is a relationship field.
Relationship Name
CodeSetServiceType
Relationship Type
Lookup
Refers To
CodeSet
CoverageBenefitId
Type
reference
Properties
Create, Filter, Group, Sort
Description
The ID of the covered benefit this item belongs to.
This is a relationship field.
Relationship Name
CoverageBenefit
Relationship Type
Lookup
Refers To
CoverageBenefit
CoverageLevel
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
Description of the level of coverage provided by this item.
DoesDeductibleApply
Type
boolean
Properties
Create, Defaulted on create, Filter, Group, Sort, Update
Description
Specifies whether the benefit item requires a prior expenditure by the patient.
The default value is 'false'.
InNetworkCoverage
Type
textarea
Properties
Create, Nillable, Update
Description
Description of the in network coverage provided by this item.
IsActive
Type
boolean
Properties
Create, Defaulted on create, Filter, Group, Sort, Update
Description
Specifies whether the benefit item is currently available.
The default value is 'false'.
IsInPlanNetwork
Type
boolean
Properties
Create, Defaulted on create, Filter, Group, Sort, Update
Description
Indicates if the benefit is only available in the plan network.
The default value is 'false'.
IsPreauthorizationRequired
Type
boolean
Properties
Create, Defaulted on create, Filter, Group, Sort, Update
Description
Specifies whether the service must be approved before use.
The default value is 'false'.
LastReferencedDate
Type
dateTime
Properties
Filter, Nillable, Sort
Description
The timestamp for when the current user last viewed a record related to this record.
LastViewedDate
Type
dateTime
Properties
Filter, Nillable, Sort
Description
The timestamp for when the current user last viewed this record. If this value is null, it’s possible that this record was referenced (LastReferencedDate) and not viewed.
MemberId
Type
reference
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
The ID of the member receiving this benefit item.
This is a relationship field.
Relationship Name
Member
Relationship Type
Lookup
Refers To
Account
Name
Type
string
Properties
Create, Filter, Group, idLookup, Sort, Update
Description
Name of this coverage benefit item.
Notes
Type
textarea
Properties
Create, Nillable, Update
Description
Additional information about this coverage benefit item.
OutofNetworkCoverage
Type
textarea
Properties
Create, Nillable, Update
Description
Description of the coverage for non-preferred providers.
OwnerId
Type
reference
Properties
Create, Defaulted on create, Filter, Group, Sort, Update
Description
The ID of the user who owns this record.
This is a polymorphic relationship field.
Relationship Name
Owner
Relationship Type
Lookup
Refers To
Group, User
ServiceType
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
The type of service this plan benefit item provides.
ServiceTypeCode
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
The code for the type of service this plan benefit item provides.
SourceSystem
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
The name of the system this coverage benefits item record came from.
SourceSystemIdentifier
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
The identifier of the CoverageBenefitItem in its source system.
SourceSystemModified
Type
dateTime
Properties
Create, Filter, Nillable, Sort, Update
Description
The ID of this coverage benefits item record on its source system.
SourceSystemModified
Type
dateTime
Properties
Create, Filter, Nillable, Sort, Update
Description
The date on which this coverage benefits item was last changed on the source system.
TimePeriod
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
A description of the period this plan benefit item covers.