CareBenefitVerifyRequest

Request for verification of benefits. This object is available in API version 53.0 and later.

Supported Calls 

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

Fields 

AssignedToId 

  • Type: reference

  • Properties: Create, Filter, Group, Nillable, Sort, Update

  • Description: The user assigned to the care benefit verify request.

    This field is a relationship field.

    This field is available in API version 62.0 and later.

  • Relationship Name: AssignedTo

  • Refers To: User

AuthorizedPrescriptionId 

  • Type: reference

  • Properties: Create, Filter, Group, Nillable, Sort, Update

  • Description: The authorized prescription associated with the care benefit verify request.

    This field is a relationship field.

    This field is available in API version 61.0 and later with the Manage Pharmacy Benefits Verification permission set.

  • Relationship Name: AuthorizedPrescription

  • Relationship Type: Lookup

  • Refers To: MedicationRequest

BenefitCategoryCodeId 

  • Type: reference

  • Properties: Create, Filter, Group, Nillable, Sort, Update

  • Description: The benefit category code associated with the care benefit verify request.

    This field is a relationship field.

    This field is available in API version 61.0 and later with the Manage Pharmacy Benefits Verification permission set.

  • Relationship Name: BenefitCategoryCode

  • Relationship Type: Lookup

  • Refers To: CodeSet

BillablePrdEndDateTime 

  • Type: dateTime

  • Properties: Create, Filter, Nillable, Sort, Update

  • Description: The date and time when billable period ended.

    This field is available in API version 61.0 and later with the Manage Pharmacy Benefits Verification permission set.

BillablePrdStartDateTime 

  • Type: dateTime

  • Properties: Create, Filter, Nillable, Sort, Update

  • Description: The date and time when billable period started.

    This field is available in API version 61.0 and later with the Manage Pharmacy Benefits Verification permission set.

CareProgramEnrolleeId 

  • Type: reference

  • Properties: Create, Filter, Group, Nillable, Sort, Update

  • Description: The care program enrollee associated with the care benefit verify request.

    This field is a relationship field.

    This field is available in API version 62.0 and later.

  • Relationship Name: CareProgramEnrollee

  • Refers To: CareProgramEnrollee

CareProgramId 

  • Type: reference

  • Properties: Filter, Group, Nillable, Sort

  • Description: The care program associated with the care benefit verify request.

    This field is a relationship field.

    This field is available in API version 62.0 and later with the Manage Pharmacy Benefits Verification permission set.

  • Relationship Name: CareProgram

  • Refers To: CareProgram

CaseId 

  • Type: reference

  • Properties: Create, Filter, Group, Nillable, Sort, Update

  • Description: Identifies the associated case.

    This field is a relationship field.

  • Relationship Name: Case

  • Relationship Type: Lookup

  • Refers To: Case

CoverageBenefitId 

  • Type: reference

  • Properties: Create, Filter, Group, Nillable, Sort, Update

  • Description: Identifies the set of services covered by the insurance plan.

    This field is a relationship field.

  • Relationship Name: CoverageBenefit

  • Relationship Type: Lookup

  • Refers To: CoverageBenefit

InitialFillDuration 

  • Type: double

  • Properties: Filter, Nillable, Sort

  • Description: The initial fill duration of the authorized prescription.

    This field is available in API version 62.0 and later with the Manage Pharmacy Benefits Verification permission set.

InitialFillQuantity 

  • Type: double

  • Properties: Filter, Nillable, Sort

  • Description: The initial fill quantity of the authorized prescription.

    This field is available in API version 62.0 and later with the Manage Pharmacy Benefits Verification permission set.

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.

MemberPlanId 

  • Type: reference

  • Properties: Create, Filter, Group, Sort

  • Description: Identifies the member plan that includes the benefit item being verified.

    This field is a relationship field.

  • Relationship Name: MemberPlan

  • Relationship Type: Lookup

  • Refers To: MemberPlan

Name 
  • Type: string
  • Properties: Autonumber, Defaulted on create, Filter, idLookup, Sort
  • Description: The name of the care benefit verification request.

OriginalPrescriptionId 

  • Type: reference

  • Properties: Create, Filter, Group, Nillable, Sort, Update

  • Description: The original prescription associated with the care benefit verify request.

    This field is a polymorphic relationship field.

    This field is available in API version 61.0 and later with the Manage Pharmacy Benefits Verification permission set.

  • Relationship Name: OriginalPrescription

  • Relationship Type: Lookup

  • Refers To: MedicationRequest

PayerId 

  • Type: reference

  • Properties: Create, Filter, Group, Nillable, Sort, Update

  • Description: The payer associated with the care benefit verify request.

    This field is a relationship field.

    This field is available in API version 61.0 and later with the Manage Pharmacy Benefits Verification permission set.

  • Relationship Name: Payer

  • Relationship Type: Lookup

  • Refers To: Account

PlanId 

  • Type: reference

  • Properties: Filter, Group, Nillable, Sort

  • Description: The purchaser plan from the member plan associated with the care program enrollee.

    This field is a relationship field.

    This field is available in API version 62.0 and later with the Manage Pharmacy Benefits Verification permission set.

  • Relationship Name: Plan

  • Refers To: PurchaserPlan

PrescriberId 

  • Type: reference

  • Properties: Create, Filter, Group, Nillable, Sort, Update

  • Description: The prescriber associated with the care benefit verify request.

    This field is a relationship field.

    This field is available in API version 61.0 and later with the Manage Pharmacy Benefits Verification permission set.

  • Relationship Name: Prescriber

  • Relationship Type: Lookup

  • Refers To: HealthcareProvider

PrescriptionMedicationId 

  • Type: reference

  • Properties: Filter, Group, Nillable, Sort

  • Description: The medication code or medication name of the authorized prescription.

    This field is a polymorphic relationship field.

    This field is available in API version 62.0 and later with the Manage Pharmacy Benefits Verification permission set.

  • Relationship Name: PrescriptionMedication

  • Refers To: CodeSetBundle, Medication

PriorityCodeId 

  • Type: reference

  • Properties: Create, Filter, Group, Nillable, Sort, Update

  • Description: The priority code associated with the care benefit verify request.

    This field is a relationship field.

    This field is available in API version 61.0 and later with the Manage Pharmacy Benefits Verification permission set.

  • Relationship Name: PriorityCode

  • Relationship Type: Lookup

  • Refers To: CodeSet

ProviderId 

  • Type: reference

  • Properties: Create, Filter, Group, Nillable, Sort, Update

  • Description: The provider of the care benefit verify request.

    This field is a polymorphic relationship field.

    This field is available in API version 61.0 and later with the Manage Pharmacy Benefits Verification permission set.

  • Relationship Name: Provider

  • Relationship Type: Lookup

  • Refers To: Account, HealthcareProvider

RelatedCareBnftVerifyRequestId 

  • Type: reference

  • Properties: Create, Filter, Group, Nillable, Sort, Update

  • Description: The original care benefit verify request from which the current request is cloned.

    This field is a relationship field.

    This field is available in API version 62.0 and later.

  • Relationship Name: RelatedCareBnftVerifyRequest

  • Refers To: CareBenefitVerifyRequest

Request 
  • Type: textarea
  • Properties: Create, Nillable, Update
  • Description: The JSON request body sent to an external system for care benefit verification.

RequestDate 
  • Type: dateTime
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: Date of verification request.

RequestedById 

  • Type: reference

  • Properties: Create, Filter, Group, Nillable, Sort, Update

  • Description: Person or organization requesting verification.

    This field is a relationship field.

  • Relationship Name: RequestedBy

  • Relationship Type: Lookup

  • Refers To: User

RequesterId 

  • Type: reference

  • Properties: Create, Filter, Group, Nillable, Sort, Update

  • Description: The requester associated with the care benefit verify request.

    This field is a polymorphic relationship field.

    This field is available in API version 61.0 and later with the Manage Pharmacy Benefits Verification permission set.

  • Relationship Name: Requester

  • Relationship Type: Lookup

  • Refers To: Account, HealthcareProvider

ResponseBody 
  • Type: base64
  • Properties: Create, Nillable, Update
  • Description: Full JSON response from external system.

ResponseContentType 

  • Type: picklist

  • Properties: Create, Filter, Group, Nillable, Restricted picklist, Sort, Update

  • Description: The content type of the response from the external system.

  • Possible values:

    • application/html
    • application/java-archive
    • application/javascript
    • application/json
    • application/msword
    • application/octet-stream
    • application/octet-stream;type=unknown
    • application/opx
    • application/pdf
    • application/postscript
    • application/rtf
    • application/vnd.box.notes
    • application/vnd.google-apps.document
    • application/vnd.google-apps.drawing
    • application/vnd.google-apps.form
    • application/vnd.google-apps.presentation
    • application/vnd.google-apps.script
    • application/vnd.google-apps.spreadsheet
    • application/vnd.ms-excel
    • application/vnd.ms-excel.sheet.macroEnabled.12
    • application/vnd.ms-infopath
    • application/vnd.ms-powerpoint
    • application/vnd.ms-powerpoint.presentation.macroEnabled.12
    • application/vnd.ms-word.document.macroEnabled.12
    • application/vnd.oasis.opendocument.presentation
    • application/vnd.oasis.opendocument.spreadsheet
    • application/vnd.oasis.opendocument.text
    • application/vnd.openxmlformats-officedocument.presentationml.presentation
    • application/vnd.openxmlformats-officedocument.presentationml.slideshow
    • application/vnd.openxmlformats-officedocument.presentationml.template
    • application/vnd.openxmlformats-officedocument.spreadsheetml.sheet
    • application/vnd.openxmlformats-officedocument.spreadsheetml.template
    • application/vnd.openxmlformats-officedocument.wordprocessingml.document
    • application/vnd.openxmlformats-officedocument.wordprocessingml.template
    • application/vnd.visio
    • application/x-gzip
    • application/x-java-source
    • application/x-javascript
    • application/x-shockwave-flash
    • application/x-sql
    • application/x-zip-compressed
    • application/xhtml+xml
    • application/xml
    • application/zip
    • audio/mp4
    • audio/mpeg
    • audio/ogg
    • audio/x-aac
    • audio/x-ms-wma
    • audio/x-ms-wmv
    • audio/x-wav
    • image/bmp
    • image/gif
    • image/jpeg
    • image/jpeg;type=mobile
    • image/png
    • image/svg+xml
    • image/tiff
    • image/vnd.adobe.photoshop
    • image/vnd.dwg
    • image/x-photoshop
    • message/rfc822
    • model/vnd.usdz+zip
    • text/css
    • text/csv
    • text/html
    • text/plain
    • text/rtf
    • text/snote
    • text/stypi
    • text/vnd.salesforce.quip-chat
    • text/vnd.salesforce.quip-doc
    • text/vnd.salesforce.quip-sheet
    • text/vnd.salesforce.quip-slides
    • text/vnd.salesforce.quip-template
    • text/vtt
    • text/webviewhtml
    • text/x-c
    • text/x-c++
    • text/xml
    • video/mp4
    • video/mpeg
    • video/ogg
    • video/quicktime
    • video/x-m4v
    • video/x-ms-asf
    • video/x-msvideo

ResponseLength 
  • Type: int
  • Properties: Filter, Group, Nillable, Sort
  • Description: The length of the response from the external system.

ResponseName 
  • Type: string
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: The name of the response from the external system.

Status 

  • Type: picklist

  • Properties: Create, Filter, Group, Nillable, Restricted picklist, Sort, Update

  • Description: Status of the verification request.

  • Possible values:

    • Acknowledged
    • Completed
    • Copy
    • Error
    • Partial
    • Pending
    • Rejected
    • TimedOut—Timed Out
    • Verified
    • Pending Confirmation
    • Receieved Confirmation
    • Ready for Verification

StatusReason 
  • Type: textarea
  • Properties: Create, Nillable, Update
  • Description: The reason for the specified status of the care benefit verification request.

VerificationMode 

  • Type: picklist

  • Properties: Create, Filter, Group, Nillable, Restricted picklist, Sort, Update

  • Description: Specifies the mode of verification used in the care benefit verify request.

    This field is available in API version 63.0 and later with the Manage Pharmacy Benefits Verification permission set.

  • Possible values:

    • Electronic
    • Manual

Associated Objects 

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.

CareBenefitVerifyRequestChangeEvent (API version 60.0)

Change events are available for the object.

CareBenefitVerifyRequestFeed

Feed tracking is available for the object.

CareBenefitVerifyRequestHistory

History is available for tracked fields of the object.

Health Cloud Developer Guide
Health Cloud Data Model
Advanced Therapy Management
Adverse Events
Assessment Generation
Benefits Verification
CareBenefitVerifyRequest
CoverageBenefit
CoverageBenefitItem
CoverageBenefitItemLimit
MemberPlan
PurchaserPlan
Care Program Management
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
ProductRequest
Health Cloud Associated Objects
Health Cloud Fields on Standard Objects
Health Cloud Platform Events
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
Health Cloud FHIR APIs
MuleSoft Direct Integrations
API End-of-Life Policy
Health Cloud Managed Package
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