Set up Data for Benefit Verification

Verify that you have the back end data in place so that benefit verification can work.

Available in: Lightning Experience

Available in: Enterprise and Unlimited Editions with Health Cloud

Verify that each patient is represented in an Account record.
Verify that the Purchaser Plan object is populated with information about the coverage plans that are available to your users.
The Verifiable field must be set to True, and the Plan Type field must be populated.

Verify that each patient is connected with a coverage set using a Member Plan record.

This is where the information that's visible to the user comes from. For best results, make sure these fields are populated:

UI Field	Source Field	Sample Data
Member Plan Name	MemberPlan.Name	Plan 1
Member Number	MemberPlan.MemberNumber	MN1234
Group Member	MemberPlan.GroupNumber	GN4321
Effective From	MemberPlan.EffectiveFrom	"Jan 1, 2020"
Effective To	MemberPlan.EffectiveTo	"Dec 31, 2021"
Relationship to Subscriber	MemberPlan.RelationshipToSubscriber	Self

Create an Identifier record where the Parent Record is the value of the Payer field on the MemberPlan object.
Populate the Code Set object with the Service Type Codes you need.
You can have up to 180 codes. See the X12 Service Type Codes reference for a full list.
1. In the Code Set object, add a value to the Code Set Type picklist field for service type codes.
  Call it something descriptive, like Service Type Codes for Benefit Verification.
2. Create service type codes by selecting the picklist value in the Code Set Type field.

Health Cloud Administration