PlanBenefitItem

Represents the details of a benefit available under a purchaser’s plan that is offered to their members.

Supported Calls

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

Fields

BenefitCategory

Type: string
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: Name of the benefit category this item belongs to.

CoverageLevel

Type: string
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: Description of the level of coverage provided.

FrequencyType

Type: picklist
Properties: Create, Filter, Group, Nillable, Restricted picklist, Sort, Update
Description: The frequency type of the plan benefit item associated with the home healthcare visit.

This field is available in API version 66.0 and later with the Home Health add-on license.
Possible values:
- Daily
- Fortnightly
- Monthly
- Quarterly
- Weekly
- Yearly

InNetworkCoverage

Type: currency
Properties: Create, Filter, Nillable, Sort, Update
Description: The amount available to contribute towards treatment costs for each treatment undertaken by the health plan’s preferred providers.

IsInPlanNetwork

Type: boolean
Properties: Create, Defaulted on create, Filter, Group, Sort, Update
Description: Indicates if the benefit is only available in the plan network.

ItemCodeId

Type: reference
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: The code of the plan benefit item.

This field is a polymorphic relationship field.

This field is available in API version 64.0 and later.
Relationship Name: ItemCode
Refers To: CodeSet, CodeSetBundle

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.

Name

Type: string
Properties: Create, Filter, Group, Sort, Update
Description: Name of this benefit item.

Notes

Type: textarea
Properties: Create, Nillable, Update
Description: Additional information about this benefit item.

OutofNetworkCoverage

Type: currency
Properties: Create, Filter, Nillable, Sort, Update
Description: The amount available to contribute towards treatment costs for each treatment undertaken by non-preferred providers.

OwnerId

Type: reference
Properties: Create, Defaulted on create, Filter, Group, Sort, Update
Description: The ID of the user who owns this record.

PauthRequirementEndDate

Type: dateTime
Properties: Create, Filter, Nillable, Sort, Update
Description: The date from which preauthorization for the plan benefit item is required or not.

This field is available in API version 64.0 and later.

PauthRequirementStartDate

Type: dateTime
Properties: Create, Filter, Nillable, Sort, Update
Description: The last date for which preauthorization for the plan benefit item is required or not.

This field is available in API version 64.0 and later.

PlanBenefitId

Type: reference
Properties: Create, Filter, Group, Sort
Description: The ID of the benefit this item belongs to.

PreauthorizationTypeCodeId

Type: reference
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: The code which represents the type of preauthorization that the plan benefit item requires.

This field is a relationship field.

This field is available in API version 64.0 and later.
Relationship Name: PreauthorizationTypeCode
Refers To: CodeSet

ServiceType

Type: string
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: The type of service this plan benefit item provides for.

ServiceTypeCode

Type: string
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: The code for the type of service this plan benefit item provides for.

SourceSystem

Type: string
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: The name of the system this benefits item record came from.

SourceSystemIdentifier

Type: string
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: The ID of this benefits item record on its source system.

SourceSystemModified

Type: date
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: The date on which this benefits item was last updated from the source system.

TimePeriod

Type: string
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: A description of the period during which services under this plan benefit item are to be rendered or continued.

Associated Objects

This object has the following associated objects. Unless noted, they are available in the same API version as this object.

PlanBenefitItemChangeEvent (API version 60.0): Change events are available for the object.
PlanBenefitItemFeed: Feed tracking is available for the object.
PlanBenefitItemHistory: History is available for tracked fields of the object.
PlanBenefitItemOwnerSharingRule: Sharing rules are available for the object.
PlanBenefitItemShare: Sharing is available for the object.