Salesforce Health Cloud Developer Guide

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Health Cloud Developer Guide
Health Cloud Data Model
Advanced Therapy Management
Adverse Events
Assessment Generation
Benefits Verification
Care Program Management
Claims
ClaimHeader__x
ClaimDiagnosisProcedure__x
ClaimProvider__x
ClaimLine__x
ClaimDiagnosis__x
Clinical Data Model
Predecessors to Code Sets and Code Set Bundles in Health Cloud
Coverage Requirement Discovery
Crisis Support Center Management
Documentation Templates and Rules
Disease Surveillance
Electronic Signatures
Engagement Interaction
FHIR Subscription
Financial Assistance Program
Health Assessments
Health Insurance
Home Health
Integrated Care Management
Intelligent Appointment Management
Intelligent Document Automation
Intelligent Sales
Medication Management
Patient Program Outcome Management
Participant Management
Patient Segmentation
Pharmacy Benefits Verification
Provider Network Management
Provider Relationship Management
Remote Monitoring and Device Registration
Social Determinants
Timeline
Unified Health Scoring
Utilization Management
Health Cloud Associated Objects
Health Cloud Fields on Standard Objects
Working With Electronic Health Records
Emergency Response Management
Apex Reference
Health Cloud Business APIs
Health Cloud Tooling API Objects
Health Cloud Standard Invocable Actions
Metadata Types
API End-of-Life Policy
PDF

ClaimHeader__x

Contains summary information about the claim, such as the payment amount, specified medications, and billing data.

Supported Calls

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

Fields

Field Details
AcceptedOn__c
Type
date
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
Date on which the claim was accepted.
AdjudicatedAmount__c
Type
currency
Properties
Create, Filter, Nillable, Sort, Update
Description
Amount paid for the service by primary payer.
AdjudicatedOn__c
Type
date
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
Date on which adjudication amount was paid by the primary payer.
BilledDRGCode__c
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
Diagnosis-related group (DRG) code used for billing.
ClaimAmount__c
Type
Currency
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
Amount submitted with the original claim.
ClaimNumber__c
Type
Text(64)
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
Number assigned to the claim.
ClaimStatusId__c
Type
Reference
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
Current status of the claim.
DisplayUrl
Type
url
Properties
Create, Filter, Nillable, Sort, Update
Description
ExternalId
Type
string
Properties
Create, Defaulted on create, Filter, Nillable, Sort, Update
Description
DrugName__c
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
Name of the drug.
DrugQuantity__c
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
Authorized quantity per refill.
DrugSupplyDays__c
Type
double
Properties
Create, Filter, Nillable, Sort, Update
Description
Number of days the supply is authorized for.
EDIMessage__c
Type
textarea
Properties
Create, Filter, Nillable, Sort, Update
Description
Unparsed, unfiltered, raw EDI message.
FillDate__c
Type
date
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
Date on which the drug was filled by the pharmacy.
FormularyTier__c
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
The formulary tier level for the drug.
HIC3ClassCode__c
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
Hierarchical Specific Therapeutic (HIC3) class code assigned to the service.
IsFormularyStatus__c
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
Indicates whether the drug is approved for coverage.
IsGeneric__c
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
Indicates whether the drug is generic.
IsRefillAuthorized__c
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
Indicates whether refills for the drug are authorized.
MemberPlanId__c
Type
reference
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
ID of member plan that this claim is related to.
Name__c
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
Name of the claim record.
NDC__c
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
National Drug Code (NDC) identification number.
PartBorPartD__c
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
Indicates whether the drug has Medicare Part B or Part D coverage.
PayerId__c
Type
reference
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
ID of the payer that this claim is related to.
PaymentDate__c
Type
date
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
Date on which claim was paid out.
PreauthNumber__c
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
Preauthorization number for the service.
ReferralNumber__c
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
ID of the referral for the service.
SourceSystem__c
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
Name of the system where this claim originated.
SourceSystemIdentifier__c
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
ID of the system where this claim was sourced from.
SourceSystemModified__c
Type
dateTime
Properties
Create, Filter, Nillable, Sort, Update
Description
Timestamp of the most recent update from the source system.
StandardGenericTherapeuticClass__c
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
Therapeutic drug category according to the American Hospital Formulary Service (AHFS) classification system.
StandardTherapeuticClassDescription__c
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
Description of the therapeutic category of drug according to the American Hospital Formulary Service (AHFS) classification system.
SubmittedOn__c
Type
date
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
Claim submission date.
Type__c
Type
string
Properties
Create, Filter, Group, Nillable, Sort, Update
Description
Type of claim.