acknowledgementLetterSentDate | String | Date and time when an acknowledgment letter was sent to the requester. Maps to: CareRequest.AcknowledgementLetterSentDate | Big, 46.0 | 46.0 |
actualAdmissionDate | String | Actual admission date for the patient. Maps to: CareRequest.ActualAdmissionDate | Big, 46.0 | 46.0 |
actualDischargeDate | String | Actual discharge date for the patient. Maps to: CareRequest.ActualDischargeDate | Big, 46.0 | 46.0 |
admissionNotes | String | Notes related to the admission. Maps to: CareRequest.AdmissionNotes | Big, 46.0 | 46.0 |
admissionSource | String | Where the patient was admitted from, for example, a clinic or an emergency room. Maps to: CareRequest.AdmissionSource | Big, 46.0 | 46.0 |
admissionType | String | Type of admission, for example, emergency or elective. Maps to: CareRequest.AdmissionType | Big, 46.0 | 46.0 |
ambulanceTransportDistance | Integer | Ambulance Transport Distance | Big, 46.0 | 46.0 |
ambulanceTransportReason | String | Reason for ambulance transport. Maps to: CareRequestExtention.AmbulanceTransportReason | Big, 46.0 | 46.0 |
ambulanceTransportType | String | Type of ambulance transport. Maps to: CareRequestExtention.AmbulanceTransportType | Big, 46.0 | 46.0 |
aorReceivedDate | String | Date and time when the Appointment of Representative (AOR) form was received. Maps to: CareRequest.AorReceivedDate | Big, 46.0 | 46.0 |
aorRequestedDate | String | Date and time when the AOR form was requested. Maps to: CareRequest.AorRequestedDate | Big, 46.0 | 46.0 |
appealEffectuationDateTime | String | 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. Maps to: CareRequestExtension.AppealEffectuationDateTime | Big, 52.0 | 52.0 |
appealRequestReasonType | String | Specifies the reason for raising the appeal request. Maps to: CareRequest.AppealRequestReasonType | Big, 52.0 | 52.0 |
appointedRepVerbalContactDate | String | Date and time of verbal contact with the member’s appointed representative. Maps to: CareRequest.AppointedRepVerbalContactDate | Big, 46.0 | 46.0 |
appointedRepWrittenContactDate | String | Date and time correspondence was sent to the member’s appointed representative. Maps to: CareRequest.AppointedRepWrittenContactDate | Big, 46.0 | 46.0 |
appointedRepresentative | Appointed Representative | Appointed representative for the member. | Big, 46.0 | 46.0 |
approvedLengthofStay | Integer | Approved number of days for the admission. Maps to: CareRequest.ApprovedLengthOfStay | Big, 46.0 | 46.0 |
approvedLevelofCare | String | Approved level of care for the patient, for example, Hospital-Observaton or SNF-Rehabilitation. Maps to: CareRequest.ApprovedLevelOfCare | Big, 46.0 | 46.0 |
authorizationRefIdentifier | String | The unique identifier of the authorization request. Maps to: CareRequestExtension.AuthorizationRefIdentifier | Big, 57.0 | 57.0 |
careRequestReviewers | Care Request Reviewer Output[] | The care request associated with the care request reviewer. Maps to: CareRequest.CareRequestReviewers | Big, 52.0 | 52.0 |
caseSubStatus | String | Sub status of care request in each stage of care request. Maps to: CareRequest.CaseSubStatus | Big, 57.0 | 57.0 |
claimNumber | String | Claim number for the medical service or medication, if one exists. Maps to: CareRequest.ClaimNumber | Big, 46.0 | 46.0 |
clinicalCaseType | String | Clinical case type for the patient, for example, High Risk Fall or Adult Diabetes. Maps to: CareRequest.ClinicalCaseType | Big, 46.0 | 46.0 |
criteriaMet | String | Indicates whether criteria for care was met. Maps to: CareRequest.CriteriaMet | Big, 46.0 | 46.0 |
cumulativeLengthofStay | Integer | Total number of days for the admission. Maps to: CareRequest.CumulativeLengthOfStay | Big, 46.0 | 46.0 |
currentLevelofCare | String | Level of care that the patient is receiving. Maps to: CareRequest.CurrentLevelOfCare | Big, 46.0 | 46.0 |
decisionDate | String | Date by which the decision must be made for the request. Maps to: CareRequest.DecisionDate | Big, 46.0 | 46.0 |
decisionDaysRemaining | Integer | Number of days remaining for a decision or resolution. Maps to: CareRequest.DecisionDaysRemaining | Big, 46.0 | 46.0 |
decisionLetter | String | The text of the determination letter sent to the member and provider. Maps to: CareRequest.DecisionLetter | Big, 46.0 | 46.0 |
decisionNotes | String | Notes related to the decision. Maps to: CareRequest.DecisionNotes | Big, 46.0 | 46.0 |
decisionReason | String | Reason for the decision. Maps to: CareRequest.DecisionReason | Big, 46.0 | 46.0 |
decisionReasonDescription | String | Text describing the reason for the decision. Maps to: CareRequest.DecisionReasonDescription | Big, 46.0 | 46.0 |
deniedLengthofStay | Integer | Number of days denied for the admission. Maps to: CareRequest.DeniedLengthOfStay | Big, 46.0 | 46.0 |
deniedLevelofCare | String | Level of care denied for the patient. Maps to: CareRequest.DeniedLevelOfCare | Big, 46.0 | 46.0 |
dispositionNotes | String | Notes related to the disposition of the request. Maps to: CareRequest.DispositionNotes | Big, 46.0 | 46.0 |
documentAttachmentStatus | String | The status of the document upload based on the checklist provided to the reviewers. Maps to: CareRequestExtension.DocumentAttachmentStatus
Valid values are:
| Big, 55.0 | 55.0 |
dueDate | String | Date the request is due for completion. Maps to: CareRequest.DueDate | Big, 46.0 | 46.0 |
effectiveFrom | String | The start date for an effective-date range. Maps to: CareRequest.EffectiveFrom | Big, 46.0 | 46.0 |
effectiveTo | String | The end date for an effective-date range. Maps to: CareRequest.EffectiveTo | Big, 46.0 | 46.0 |
expirationDate | String | Expiration date for the request. Maps to: CareRequest.ExpirationDate | Big, 46.0 | 46.0 |
extendedRequest | Boolean | Extended Request Maps to: CareRequest. | Big, 46.0 | 46.0 |
extensionRequestReceivedDate | String | Date and time an extension was requested. Maps to: CareRequest.ExtensionRequestReceivedDate | Big, 46.0 | 46.0 |
externalComplaintID | String | Complaint ID number. Maps to: CareRequest.ExternalComplaintIdentifier | Big, 46.0 | 46.0 |
facilityRecordNumber | String | The medical record number used to identify a patient. Maps to: CareRequest.FacilityRecordNumber | Big, 46.0 | 46.0 |
facilityRoomBedType | String | Type of facility bed for the patient. Maps to: CareRequest.FacilityRoomBedType | Big, 46.0 | 46.0 |
facilityRoomNumber | String | The facility room number for the patient. Maps to: CareRequest.FacilityRoomNumber | Big, 46.0 | 46.0 |
finalLevelofCare | String | Final level of care the patient. Maps to: CareRequest.FinalLevelOfCare | Big, 46.0 | 46.0 |
firstReviewer | First Reviewer | The person who reviewed the request. | Big, 46.0 | 46.0 |
firstReviewerNotes | String | Notes from the first reviewer related to the case. Maps to: CareRequest.FirstReviewerNotes | Big, 46.0 | 46.0 |
generalPractitioner | General Practitioner | Member’s primary or general care practitioner. | Big, 46.0 | 46.0 |
generalPractitionerVerbalNotificationDate | String | Date when the primary care practitioner was verbally notified of the decision. Maps to: CareRequest.GeneralPractitionerVerbalNotifiedDate | Big, 46.0 | 46.0 |
generalPractitionerWrittenNotificationDate | String | Date when the primary care practitioner was notified of the decision by written correspondence. Maps to: CareRequest.GeneralPractitionerWrittenNotifiedDate | Big, 46.0 | 46.0 |
grievanceType | String | Specifies the type of grievance. Maps to: CareRequest.GrievanceType | Big, 52.0 | 52.0 |
healthcareProvider | String | The healthcare provider associated with the care request against whom the Grievance is filed. Maps toCareRequestExtension.HealthCareProvider | Big, 52.0 | 52.0 |
homeHealthCertificationEndDate | String | Certification end date for home health care. Maps to: CareRequestExtension.HomeHealthCertificationEndDate | Big, 46.0 | 46.0 |
homeHealthCertificationStartDate | String | Certification start date for home health care. Maps to: CareRequestExtension.HomeHealthCertificationStartDate | Big, 46.0 | 46.0 |
homeHealthStartDate | String | Date that home health services are scheduled or anticipated to start. Maps to: CareRequestExtension.HomeHealthStartDate | Big, 46.0 | 46.0 |
id | String | ID of the Care Request. | Big, 46.0 | 46.0 |
independentReviewDetermination | String | The determination made by the independent review. Maps to: CareRequestExtension.IndependentReviewDetermination | Big, 52.0 | 52.0 |
independentReviewDeterminationDate | String | The date when the determination was made by the independent review. Maps to: CareRequestExtension.IndependentReviewDeterminationDate | Big, 52.0 | 52.0 |
independentReviewSubmissionDate | String | The date when the review request was submitted for independent review. Maps to: CareRequestExtension.IndependentReviewSubmissionDate | Big, 52.0 | 52.0 |
infoReceievedDate | String | Date and time when additional information was received from the provider or member. Maps to: CareRequest.InfoReceivedDate | Big, 46.0 | 46.0 |
infoRequestedDate | String | Date and time when additional information was requested from the provider or member. Maps to: CareRequest.InfoRequestedDate | Big, 46.0 | 46.0 |
initialDenialNotificationDate | String | Date of initial denial notification. Maps to: CareRequest.InitialDenialNotificationDate | Big, 46.0 | 46.0 |
initialDenialNotificationTime | String | The time when the initial care request was denied. Maps to CareRequest.InitialDenialNotificationTime | Big, 52.0 | 52.0 |
isIndependentReviewRequired | Boolean | Indicates whether independent review is required. Maps to CareRequestExtension.IsIndependentReviewRequired | Big, 52.0 | 52.0 |
isReadmission | Boolean | Indicates whether the care request is for a readmission. Maps to CareRequest.IsReadmission | Big, 52.0 | 52.0 |
lastModifiedDate | String | Last Modified Date | Big, 46.0 | 46.0 |
medicalDirector | Medical Director | The medical director who reviewed the request. | Big, 46.0 | 46.0 |
medicalDirectorNotes | String | Notes from the medical director related to the request. Maps to: CareRequest.MedicalDirectorNotes | Big, 46.0 | 46.0 |
member | String | Insurance identifier for the member. Maps to: CareRequest.MemberId | Big, 46.0 | 46.0 |
memberContactDate | String | Member Contact Date Maps to: CareRequest. | Big, 46.0 | 46.0 |
memberGroupNumber | String | Insurance group number for the member. Maps to: CareRequest.MemberGroupNumber | Big, 46.0 | 46.0 |
memberPrimaryPlan | String | The primary insurance plan of a member associated with the care request when the member is insured under multiple plans. Maps to: CareRequest.MemberPrimaryPlan | Big, 52.0 | 52.0 |
memberSecondaryPlan | String | The secondary insurance plan of a member associated with the care request when the member is insured under multiple plans. Maps to: CareRequest.MemberSecondaryPlan | Big, 52.0 | 52.0 |
memberVerbalNotificationDate | String | Date when the member was verbally notified of the decision. Maps to: CareRequest.MemberVerbalNotificationDate | Big, 46.0 | 46.0 |
memberWrittenNotificationDate | String | Date when the member was notified of the decision by written correspondence. Maps to: CareRequest.MemberWrittenNotificationDate | Big, 46.0 | 46.0 |
modificationDate | String | Date the case was modified. Maps to: CareRequest.ModificationDate | Big, 46.0 | 46.0 |
modifiedLengthofStay | Integer | Modified number of days for the admission. Maps to: CareRequest.ModifiedLengthOfStay | Big, 46.0 | 46.0 |
modifiedLevelofCare | String | Modified level of care for the patient. Maps to: CareRequest.ModifiedLevelOfCare | Big, 46.0 | 46.0 |
nextReviewDate | String | Date the next review is scheduled for completion. Maps to: CareRequest.NextReviewDate | Big, 46.0 | 46.0 |
nursingHomeResidentialStatus | String | Nursing home resident status at the time of service. Maps to: CareRequestExtension.NursingHomeResidentialStatus | Big, 46.0 | 46.0 |
originalDenialMedicalDirector | Original Denial Medical Director | The medical director who denied the original request. | Big, 46.0 | 46.0 |
parProvider | String | Indicator of whether this provider has entered into an agreement with the insurance carrier. Maps to: CareRequest.ParProvider | Big, 46.0 | 46.0 |
placeofService | String | Place of service for the member’s care such as an inpatient hospital or an ambulatory surgery center. Maps to: CareRequest.PlaceOfService | Big, 46.0 | 46.0 |
practitionerContactDate | String | Date and time when the provider was contacted. Maps to: CareRequest.PractitionerContactDateTime | Big, 46.0 | 46.0 |
priorDischargeStatus | String | Specifies the previous discharge status of the member. Maps to: CareRequestExtension.PriorDischargeStatus | Big, 52.0 | 52.0 |
quantity | Integer | Quantity of the request. | Big, 46.0 | 46.0 |
quantityType | String | Quantity type for the request such as days, units, or visits. Maps to: CareRequest.QuantityType | Big, 46.0 | 46.0 |
receivedDate | String | Date the request was received. Maps to: CareRequest.ReceivedDate | Big, 46.0 | 46.0 |
reconsiderationDenialNotificationDate | String | Date of reconsideration denial notification. Maps to: CareRequest.ReconsiderationDenialNotificationDate | Big, 46.0 | 46.0 |
reconsiderationDenialNotificationTime | String | The time of reconsideration denial notification. Maps to: CareRequest.ReconsiderationDenialNotificationTime | Big, 52.0 | 52.0 |
recordType | String | Record type of the care request object. | Big, 46.0 | 46.0 |
referenceCareRequestCase | String | The reference care request case number associated with the care request. Maps to: CareRequest.ReferenceCareRequestCase | Big, 52.0 | 52.0 |
referenceCaseNumber | String | Reference authorization number for an appeal, complaint, or grievance. Maps to: CareRequest.ReferenceCaseNumber | Big, 46.0 | 46.0 |
reopenDecisionDateTime | String | Date and time the request was reopened. Maps to: CareRequest.ReopenDecisionDateTime | Big, 52.0 | 52.0 |
reopenReason | String | Reason the request was reopened. Maps to: CareRequest.ReopenReason | Big, 46.0 | 46.0 |
reopenReasonDescription | String | Description of why the request was reopened. Maps to: CareRequest.ReopenReasonDescription | Big, 46.0 | 46.0 |
reopenRequestOutcome | String | The result of the reopen request. Maps to: CareRequestExtension.ReopenRequestOutcome | Big, 52.0 | 52.0 |
reopenRequestType | String | The type of reopen request. Maps to: CareRequestExtension.ReopenRequestType | Big, 52.0 | 52.0 |
reopenedBy | Reopened By Output | The user who reopened the care request. Maps to: CareRequestExtension.ReopenedBy | Big, 52.0 | 52.0 |
reopenedDate | String | Date the request was reopened. Maps to: CareRequest.ReopenedDate | Big, 46.0 | 46.0 |
requestExtensionReason | String | The reason for requesting the care extension. Maps to: CareRequestExtension.RequestExtensionReason | Big, 52.0 | 52.0 |
requestExtnDecisionDateTime | String | The date when the decision to extend the care request extension was made. Maps to: CareRequestExtension.RequestExtnDecisionDateTime | Big, 52.0 | 52.0 |
requestOutcome | String | Specifies the outcome of the request. Maps to: CareRequestExtension.RequestOutcome | Big, 52.0 | 52.0 |
requestOutcomeDesc | String | The description of the request outcome. Maps to: CareRequestExtension.RequestOutcomeDesc | Big, 52.0 | 52.0 |
requestType | String | Category type of the request. Maps to: CareRequestExtension.RequestType | Big, 46.0 | 46.0 |
requestedDate | String | Date the request was originally requested. Maps to: CareRequest.RequestedDate | Big, 46.0 | 46.0 |
requestedLengthOfStay | Integer | Requested length of stay for the patient. Maps to: CareRequest.RequestedLengthOfStay | Big, 57.0 | 57.0 |
requestedLevelofCare | String | Requested level of care for the patient. Maps to: CareRequest.RequestedLevelOfCare | Big, 46.0 | 46.0 |
requesterType | String | Indicates the role of the individual initiating the request. Maps to: CareRequest.RequesterType | Big, 46.0 | 46.0 |
requestingPractitioner | Requesting Practitioner | Ordering or referring practitioner for the request. | Big, 46.0 | 46.0 |
requestingPractitionerLicense | String | Requesting Practitioner License Maps to: CareRequest.RequestingPractitionerLicense | Big, 46.0 | 46.0 |
requestingPractitionerSpecialty | String | Specialty of the practitioner, for example, Family Practice or General Surgery. Maps to: CareRequest.RequestingPractitionerSpecialty | Big, 46.0 | 46.0 |
requestingPractitionerVerbalNotificationDate | String | Date when the practitioner was verbally notified of the decision. Maps to: CareRequest.RequestingPractitionerVerbalNotifiedDate | Big, 46.0 | 46.0 |
requestingPractitionerWrittenNotificationDate | String | Date when the practitioner was notified of the decision by written correspondence. Maps to: CareRequest.RequestingPractitionerWrittenNotifiedDate | Big, 46.0 | 46.0 |
resolutionDate | String | Date when the complaint, appeal, or grievance was resolved. Maps to: CareRequest.ResolutionDate | Big, 46.0 | 46.0 |
resolutionDescription | String | The resolution details provided for the complaint, appeal, or grievance. Maps to: CareRequestExtension.ResolutionDescription | Big, 52.0 | 52.0 |
resolutionLetterSentDate | String | Date and time when a resolution letter was sent to the requester. Maps to: CareRequest.ResolutionLetterSentDate | Big, 46.0 | 46.0 |
resolutionNotes | String | Resolution notes for the request. Maps to: CareRequest.ResolutionNotes | Big, 46.0 | 46.0 |
reviewDate | String | Date the review was completed. Maps to: CareRequest.ReviewDate | Big, 46.0 | 46.0 |
rootCauseNotes | String | Field for notes related to the root cause for the request. Maps to: CareRequest.RootCauseNotes | Big, 46.0 | 46.0 |
scheduledAdmissionDate | String | Anticipated admission date for the patient. Maps to: CareRequest.ScheduledAdmissionDate | Big, 46.0 | 46.0 |
scheduledDischargeDate | String | Scheduled discharge date for the patient. Maps to: CareRequest.ScheduledDischargeDate | Big, 46.0 | 46.0 |
serviceDate | String | Date when patient received the service. Maps to: CareRequest.ServiceDate | Big, 46.0 | 46.0 |
serviceLevel | String | The level of service rendered. Maps to: CareRequestExtension.ServiceLevel | Big, 46.0 | 46.0 |
serviceType | String | Classification of the type of service. Maps to: CareRequestExtention.ServiceType | Big, 46.0 | 46.0 |
serviceorMedicationReceived | Boolean | Indicates whether the member has already received the medial service or medication. Maps to: CareRequest.IsServiceOrMedicationReceived | Big, 46.0 | 46.0 |
servicingFacility | Servicing Facility | Facility where the service is being provided. | Big, 46.0 | 46.0 |
servicingPractitioner | Servicing Practitioner | Practitioner administering the service. | Big, 46.0 | 46.0 |
servicingPractitionerLicense | String | License type of the practitioner. Maps to: CareRequest.ServicingPractitionerLicense | Big, 46.0 | 46.0 |
servicingPractitionerSpecialty | String | Specialty of the practitioner. Maps to: CareRequest.ServicingPractitionerSpecialty | Big, 46.0 | 46.0 |
sourceSystem | String | System from which this request was sourced. Maps to: CareRequest.SourceSystem | Big, 46.0 | 46.0 |
sourceSystemIdentifier | String | ID of the system from which the request was sourced. Maps to: CareRequest.SourceSystemIdentifier | Big, 46.0 | 46.0 |
sourceSystemModified | String | Timestamp of the most recent update from the source system. Maps to: CareRequest.SourceSystemModified | Big, 46.0 | 46.0 |
unitOfMeasure | String | The unit of measure associated with the prior authorization request. Maps to: CareRequestExtension.UnitofMeasure | Big, 55.0 | 55.0 |
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