|
AmbulanceTransportReason
|
- Type
- picklist
- Properties
- Create, Filter, Group, Nillable, Sort, Update
- Description
- Reason for ambulance transport.
|
|
AmbulanceTransportType
|
- Type
- picklist
- Properties
- Create, Filter, Group, Nillable, Sort, Update
- Description
- Type of ambulance transport.
|
| AppealEffectuationDateTime |
- Type
- dateTime
- Properties
- Create, Filter, Nillable, Sort, Update
- Description
- The effective date of the outcome of the appeal request. For
example, if a claim was successfully appealed, this field displays
the date when the claim was paid.
|
| AuthorizationRefIdentifier |
- Type
- string
- Properties
- Create, Filter, Group, Nillable, Sort, Update
- Description
- The unique identifier of the authorization request.
- This field is available in API version 57.0 and later.
|
|
CareRequestCaseId
|
- Type
- reference
- Properties
- Create, Filter, Group, Sort
- Description
- Case related to the care request extension.
- This is a relationship field.
- Relationship Name
- CareRequestCase
- Relationship Type
- Lookup
- Refers To
- Case
|
|
CareRequestId
|
- Type
- reference
- Properties
- Create, Filter, Group, Nillable, Sort, Update
- Description
- Care request related to the care request extension.
- This is a relationship field.
- Relationship Name
- CareRequest
- Relationship Type
- Lookup
- Refers To
- CareRequest
|
| CaseSubStatus |
- Type
- picklist
- Properties
- Create, Filter, Group, Nillable, Sort, Update
- Description
- The substatus of a case related to a care request.
- Possible values are:
- Approved
- Auto Approved
- Denied
- More Information
Requested
- More Information
Required
- New Request
- Partially Approved
- Peer to Peer Review
Scheduled
- Pending Review
- Schedule Peer to Peer
Review
- This field is available in API version 56.0 and later.
|
| DocumentAttachmentStatus |
- Type
- picklist
- Properties
- Create, Filter, Group, Nillable, Restricted picklist, Sort, Update
- Description
- The status of a clinical document upload.
- Possible values are:
- This field is available in API version 55.0 and later.
|
| HealthcareProviderId |
- Type
- reference
- Properties
- Create, Filter, Group, Nillable, Sort, Update
- Description
- The healthcare provider associated with the care request against
whom the Grievance is filed
- This is a relationship field.
- Relationship Name
- HealthcareProvider
- Relationship Type
- Lookup
- Refers To
- HealthcareProvider
|
|
HomeHealthCertificationEndDate
|
- Type
- date
- Properties
- Create, Filter, Group, Nillable, Sort, Update
- Description
- Certification end date for home healthcare.
|
|
HomeHealthCertificationStartDate
|
- Type
- date
- Properties
- Create, Filter, Group, Nillable, Sort, Update
- Description
- Certification start date for home healthcare.
|
|
HomeHealthStartDate
|
- Type
- date
- Properties
- Create, Filter, Group, Nillable, Sort, Update
- Description
- Date that home health services are scheduled or anticipated to
start.
|
| IndependentReviewDetermination |
- Type
- picklist
- Properties
- Create, Filter, Group, Nillable, Restricted picklist, Sort,
Update
- Description
- The determination made by the independent review.
- Possible values are:
|
| IndependentReviewDeterminationDate |
- Type
- dateTime
- Properties
- Create, Filter, Nillable, Sort, Update
- Description
- The date when the determination was made by the independent
review.
|
| IndependentReviewSubmissionDate |
- Type
- dateTime
- Properties
- Create, Filter, Nillable, Sort, Update
- Description
- The date when the review request was submitted for independent
review.
|
| IsIndependentReviewRequired |
- Type
- boolean
- Properties
- Create, Defaulted on create, Filter, Group, Sort, Update
- Description
- Indicates whether an independent review is required
- The default value is 'false'.
|
|
IsMedicareCoverage
|
- Type
- boolean
- Properties
- Create, Defaulted on create, Filter, Group, Sort, Update
- Description
- Indicates whether the member has Medicare coverage.
|
|
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.
|
|
Name
|
- Type
- string
- Properties
- Create, Filter, Group, idLookup, Sort, Update
- Description
- Name of the care request extension.
|
|
NursingHomeResidentialStatus
|
- Type
- picklist
- Properties
- Create, Filter, Group, Nillable, Sort, Update
- Description
- Nursing home-resident status at the time of service.
|
| PriorDischargeStatus |
- Type
- picklist
- Properties
- Create, Filter, Group, Nillable, Restricted picklist, Sort,
Update
- Description
- Specifies the previous discharge status of the member.
- Possible values are:
- Discharged to court/law
enforcement.
- Discharged to home with home
health.
- Discharged to home/self
care.
- Discharged to hospice
care.
- Discharged/transferred to
LTACC.
- Discharged/transferred to
Psychiatric facility.
- Discharged/transferred to
SNF.
- Discharged/transferred to other
acute care facility.
- Expired
- Left against medical advice
(AMA).
|
| RecordTypeId |
- Type
- reference
- Properties
- Create, Filter, Group, Nillable, Sort, Update
- Description
- Category type of the request.
- This is a relationship field.
- Relationship Name
- RecordType
- Relationship Type
- Lookup
- Refers To
- RecordType
|
| ReferenceCaseType |
- Type
- picklist
- Properties
- Create, Filter, Group, Nillable, Restricted picklist, Sort,
Update
- Description
- Specifies the type of reference case that's associated with the
care request extension.
- Possible values are:
- Associated Case
- Prior Case
- This field is available in API version 58.0 and later.
|
| ReopenDecisionDateTime |
- Type
- dateTime
- Properties
- Create, Filter, Nillable, Sort, Update
- Description
- The date when the decision on the reopen request was made.
|
| ReopenRequestOutcome |
- Type
- picklist
- Properties
- Create, Filter, Group, Nillable, Restricted picklist, Sort,
Update
- Description
- The result of the reopen request.
- Possible values are:
|
| ReopenRequestType |
- Type
- picklist
- Properties
- Create, Filter, Group, Nillable, Restricted picklist, Sort,
Update
- Description
- The type of reopen request.
- Possible values are:
- Peer-to-Peer
Review
- Reconsideration
|
| RequestExtensionReason |
- Type
- textarea
- Properties
- Create, Nillable, Update
- Description
- The reason for requesting the care extension.
|
| RequestExtnDecisionDateTime |
- Type
- dateTime
- Properties
- Create, Filter, Nillable, Sort, Update
- Description
- The date when the decision to extend the care request extension
was made.
|
| RequestOutcome |
- Type
- picklist
- Properties
- Create, Filter, Group, Nillable, Restricted picklist, Sort,
Update
- Description
- Specifies the outcome of the request.
- Possible values are:
- Overturned
- Partially Pending
- Partially Upheld
- Upheld
- Voided
- Queued
- Complete
- Error
|
| RequestOutcomeDesc |
- Type
- textarea
- Properties
- Create, Nillable, Update
- Description
- The description of the request outcome.
|
|
RequestType
|
- Type
- picklist
- Properties
- Create, Filter, Group, Nillable, Sort, Update
- Description
- Category type of the request.
- Possible values are:
- Admission Review
- Concurrent Review
- Health Services
Review
- Individual
- Inpatient - Behavioral Health
Review
- Inpatient - Physical Health
Review
- Outpatient - Behavioral Health
Review
- Outpatient - Physical Health
Review
- Specialty Care
Review
|
| RequestingProviderId |
- Type
- reference
- Properties
- Create, Filter, Group, Nillable, Sort, Update
- Description
- The provider who requested a prior authorization for a care
request. This field is available in API version 55.0 and
later.
- This field is a relationship field.
- Relationship Name
- RequestingProvider
- Relationship Type
- Lookup
- Refers To
- HealthcareProvider
|
| ResolutionDescription |
- Type
- textarea
- Properties
- Create, Nillable, Update
- Description
- The description of the care request.
|
|
ServiceLevel
|
- Type
- picklist
- Properties
- Create, Filter, Group, Nillable, Sort, Update
- Description
- The level of service rendered.
|
|
ServiceType
|
- Type
- string
- Properties
- Create, Filter, Group, Nillable, Sort, Update
- Description
- Classification of the type of service.
|
| ServicingFacilityId |
- Type
- reference
- Properties
- Create, Filter, Group, Nillable, Sort, Update
- Description
- The facility where a patient receives service for a care request.
This field is available in API version 55.0 and later.
- This field is a polymorphic relationship field.
- Relationship Name
- ServicingFacility
- Relationship Type
- Lookup
- Refers To
- HealthcareFacility, HealthcarePractitionerFacility
|
| ServicingProviderId |
- Type
- reference
- Properties
- Create, Filter, Group, Nillable, Sort, Update
- Description
- The provider who provides the service for a care request. This
field is available in API version 55.0 and later.
- This field is a relationship field.
- Relationship Name
- ServicingProvider
- Relationship Type
- Lookup
- Refers To
- HealthcareProvider
|
|
SubscriberId
|
- Type
- reference
- Properties
- Create, Filter, Group, Nillable, Sort, Update
- Description
- Identifier for the person who has subscribed to the health
plan.
- This is a relationship field.
- Relationship Name
- Subscriber
- Relationship Type
- Lookup
- Refers To
- Account
|
|
SubscriberMemberIdentifier
|
- Type
- string
- Properties
- Create, Filter, Group, Nillable, Sort, Update
- Description
- Member ID for the subscriber.
|
| TotalAmbulanceTransportDistance |
- Type
- double
- Properties
- Create, Filter, Nillable, Sort, Update
- Description
- Total distance traveled during ambulance transport.
|
| UnitofMeasureId |
- Type
- reference
- Properties
- Create, Filter, Group, Nillable, Sort, Update
- Description
- The unit of measure for the quantity associated with a prior
authorization request. This field is available in API version 55.0
and later.
- This field is a relationship field.
- Relationship Name
- UnitofMeasure
- Relationship Type
- Lookup
- Refers To
- UnitOfMeasure
|