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PlanBenefitItem

Represents the details of a benefit available under a purchaser’s plan that is offered to their members.

Supported Calls

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

Fields

Field Name Details
BenefitCategory
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
Name of the benefit category this item belongs to.
CoverageLevel
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
Description of the level of coverage provided.
FrequencyType
Type
picklist
Properties
Create, Filter, Group, Nillable, Restricted picklist, Sort, Update
Description
The frequency type of the plan benefit item associated with the home healthcare visit.
Possible values are:
  • Daily
  • Fortnightly
  • Monthly
  • Quarterly
  • Weekly
  • Yearly
This field is available in API version 66.0 and later with the Home Health add-on license.
InNetworkCoverage
Type
currency
Properties
Create, Filter, Nillable, Sort, Update
Description
The amount available to contribute towards treatment costs for each treatment undertaken by the health plan’s preferred providers.
IsInPlanNetwork
Type
boolean
Properties
Create, Defaulted on create, Filter, Group, Sort, Update
Description
Indicates if the benefit is only available in the plan network.
ItemCodeId
Type
reference
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
The code of the plan benefit item.
This field is a polymorphic relationship field.
This field is available in API version 64.0 and later.
Relationship Name
ItemCode
Refers To
CodeSet, CodeSetBundle
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, Sort, Update
Description
Name of this benefit item.
Notes
Type
textarea
Properties
Create, Nillable, Update
Description
Additional information about this benefit item.
OutofNetworkCoverage
Type
currency
Properties
Create, Filter, Nillable, Sort, Update
Description
The amount available to contribute towards treatment costs for each treatment undertaken by 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.
PauthRequirementEndDate
Type
dateTime
Properties
Create, Filter, Nillable, Sort, Update
Description
The date from which preauthorization for the plan benefit item is required or not.
This field is available in API version 64.0 and later.
PauthRequirementStartDate
Type
dateTime
Properties
Create, Filter, Nillable, Sort, Update
Description
The last date for which preauthorization for the plan benefit item is required or not.
This field is available in API version 64.0 and later.
PlanBenefitId
Type
reference
Properties
Create, Filter, Group, Sort
Description
The ID of the benefit this item belongs to.
PreauthorizationTypeCodeId
Type
reference
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
The code which represents the type of preauthorization that the plan benefit item requires.
This field is a relationship field.
This field is available in API version 64.0 and later.
Relationship Name
PreauthorizationTypeCode
Refers To
CodeSet
ServiceType
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
The type of service this plan benefit item provides for.
ServiceTypeCode
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
The code for the type of service this plan benefit item provides for.
SourceSystem
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
The name of the system this benefits item record came from.
SourceSystemIdentifier
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
The ID of this benefits item record on its source system.
SourceSystemModified
Type
date
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
The date on which this benefits item was last updated from the source system.
TimePeriod
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
A description of the period during which services under this plan benefit item are to be rendered or continued.

Associated Objects

This object has the following associated objects. Unless noted, they are available in the same API version as this object.

PlanBenefitItemChangeEvent (API version 60.0)
Change events are available for the object.
PlanBenefitItemFeed
Feed tracking is available for the object.
PlanBenefitItemHistory
History is available for tracked fields of the object.
PlanBenefitItemOwnerSharingRule
Sharing rules are available for the object.
PlanBenefitItemShare
Sharing is available for the object.