ClaimCoveragePaymentDetail

AdjustedAmount

• Type: currency
• Properties: Create, Filter, Nillable, Sort, Update
• Description: The amount the insurance carrier intends to pay for a loss or benefit after making adjustments for deductibles, copay, or coinsurance.

BenefitName

• Type: string
• Properties: Create, Filter, Group, Nillable, Sort, Update
• Description: The name of the benefit associated with the claim coverage payment detail.

ClaimCoverageId

• Type: reference
• Properties: Create, Filter, Group, Sort, Update
• Description: The Claim Coverage associated with the Claim Coverage Payment Detail.

  This field is a relationship field.

• Relationship Name: ClaimCoverage
• Relationship Type: Lookup
• Refers To: ClaimCoverage

ClaimCoverageReserveDetailId

• Type: reference
• Properties: Create, Filter, Group, Nillable, Sort, Update
• Description: The Claim Coverage Reserve Detail associated with the Claim Coverage Payment Detail.

  This field is a relationship field.

• Relationship Name: ClaimCoverageReserveDetail
• Relationship Type: Lookup
• Refers To: ClaimCoverageReserveDetail

ClaimParticipantRecipientId

• Type: reference
• Properties: Create, Filter, Group, Nillable, Sort, Update
• Description: The Claim Participant Recipient associated with the Claim Coverage Payment Detail.

  This field is a relationship field.

• Relationship Name: ClaimParticipantRecipient
• Relationship Type: Lookup
• Refers To: ClaimParticipant

ClaimPaymentSummaryId

• Type: reference
• Properties: Create, Filter, Group, Nillable, Sort, Update
• Description: The Claim Payment Summary issued to the Claim Participant Recipient for the Claim Coverage Payment Detail.

  This field is a relationship field.

• Relationship Name: ClaimPaymentSummary
• Relationship Type: Lookup
• Refers To: ClaimPaymentSummary

ClaimPayoutPlanId

• Type: reference
• Properties: Create, Filter, Group, Nillable, Sort, Update
• Description: The Claim Payout Plan associated with the Claim Coverage Payment Detail.

  This field is a relationship field.

• Relationship Name: ClaimPayoutPlan
• Relationship Type: Lookup
• Refers To: ClaimPayoutPlan

ClaimedAmount

• Type: currency
• Properties: Create, Filter, Nillable, Sort, Update
• Description: The amount claimed by the claimant or service provider to pay for a loss or benefit.

CurrencyIsoCode

• Type: picklist
• Properties: Create, Defaulted on create, Filter, Group, Nillable, Restricted picklist, Sort, Update
• Description: If multiple currencies are enabled, this field contains the currency ISO code associated with the record.
• Default value: USD
• Possible values:
  • AED—UAE Dirham
  • CAD—Canadian Dollar
  • GBP—British Pound
  • JPY—Japanese Yen
  • USD—U.S. Dollar

Description

• Type: textarea
• Properties: Create, Nillable, Update
• Description: The description of the claim coverage.

ExGratiaAmount

• Type: currency
• Properties: Create, Filter, Nillable, Sort, Update
• Description: The amount paid over the remaining limit amount.

  Available in API version 66.0 and later.

ExGratiaLimitCount

• Type: int
• Properties: Create, Filter, Group, Nillable, Sort, Update
• Description: The count over the remaining limit count.

  Available in API version 66.0 and later.

ExGratiaReason

• Type: string
• Properties: Create, Filter, Group, Nillable, Sort, Update
• Description: The reason for the ex gratia payment.

  Available in API version 66.0 and later.

IsEditLocked

• Type: boolean
• Properties: Create, Defaulted on create, Filter, Group, Sort, Update
• Description: Indicates whether the record fields are locked for updates (true) or not (false).

  Available in API version 67.0 and later.

• Default value: false

LastReferencedDate

• Type: dateTime
• Properties: Filter, Nillable, Sort
• Description: The timestamp when the current user last accessed this record, a record related to this record, or a list view.

LastViewedDate

• Type: dateTime
• Properties: Filter, Nillable, Sort
• Description: The timestamp when the current user last viewed this record or list view.

LimitUnitCount

• Type: int
• Properties: Create, Filter, Group, Nillable, Sort, Update
• Description: The unit count that the payment detail represents.

LimitUnitOfMeasure

• Type: picklist
• Properties: Create, Filter, Group, Nillable, Sort, Update
• Description: Specifies the unit of measure that the payment detail represents.
• Possible values:
  • Days
  • Visits

Name

• Type: string
• Properties: Create, Filter, Group, idLookup, Sort, Update
• Description: The name of the claim coverage payment detail.

OperationNumber

• Type: int
• Properties: Filter, Group, Nillable, Sort
• Description: The operation number that's assigned to the record.

  Available in API version 66.0 and later.

PaymentRequestLineId

• Type: reference
• Properties: Create, Filter, Group, Nillable, Sort, Update
• Description: The Payment Request Line associated with the Claim Coverage Payment Detail.

  This field is a relationship field.

• Relationship Name: PaymentRequestLine
• Relationship Type: Lookup
• Refers To: PaymentRequestLine

PaymentStatus

• Type: picklist
• Properties: Create, Filter, Group, Nillable, Restricted picklist, Sort, Update
• Description: Specifies the payment status of claim coverage payment detail. This field is available from API version 65.0 and later.
• Possible values:
  • Cancelled
  • Deleted
  • Draft
  • Paid

ScheduledPaymentDate

• Type: dateTime
• Properties: Create, Filter, Nillable, Sort, Update
• Description: The date on which the payment is scheduled.

Status

• Type: picklist
• Properties: Create, Filter, Group, Nillable, Sort, Update
• Description: Specifies the status of claim coverage payment detail.
• Possible values:
  • Authority Approved
  • Authority Denied
  • Cancelled
  • Closed W/O Pay
  • New
  • Open
  • Paid
  • Payment Pending
  • Pending Authority
  • Stopped

Type

• Type: picklist
• Properties: Create, Filter, Group, Nillable, Restricted picklist, Sort, Update
• Description: Specifies the type of claim coverage payment detail.
• Possible values:
  • Expense
  • Loss

This object has the following associated objects. If the API version isn’t specified, they’re available in the same API versions as this object. Otherwise, they’re available in the specified API version and later.

ClaimCoveragePaymentDetailChangeEvent

Change events are available for the object in API version 63.0 and later.