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superbill-insurances.tsv

Super bill insurance data of a patient

Field Name Data type Field Description
PatientPracticeGuid Guid Unique identifier representing a patient
BillingHeaderGuid Guid Unique identifier for the billing header
BillingPatientInsuranceName String The name of a billing patient’s insurance
PatientInsurancePlanGuid Guid Unique identifier for a patient’s insurance plan
InsuredPolicyIdentifier String A unique code associated with the insurance plan
GroupIdentifier String The group number associated with the insurance plan
PlanName String Name of the insurance plan
DisplaySequence Int32 The sequence in which patient’s insurance plan data is displayed
InsuranceStreet1 String Insurance company’s street address 1
InsuranceStreet2 String Insurance company’s street address 2
InsuranceCity String Insurance company’s address city
InsuranceState String Insurance company’s address state
InsuranceZipCode String Insurance company’s address zip code
InsuranceCountry String Insurance company’s address country
ContactFirstName String The first name of a patient’s insurance plan claim contact
ContactMiddleName String The middle name of a patient’s insurance plan claim contact
ContactLastName String The last name of a patient’s insurance plan claim contact
ContactPhone String Patient insurance plan contact phone number
PlanEffectiveDate DateTime? The date and time a patient insurance plan begins
PlanExpirationDate DateTime? The date and time a patient insurance plan expires
PlanType String Type of insurance plan
Relationship String Type of relationship insurance plan payer has to patient
SubscriberFirstName String The first name for the insurance subscriber
SubscriberMiddleName String The middle name for the insurance subscriber
SubscriberLastName String The last name for the insurance subscriber
SubscriberPrimaryPhone String The primary phone for the insurance subscriber
SubscriberPrimaryPhoneExtension String The primary phone extension for the insurance subscriber
SubscriberSecondaryPhone String The secondary phone for the insurance subscriber
SubscriberSecondaryPhoneExtension String The secondary phone extension for the insurance subscriber
SubscriberTertiaryPhone String The tertiary phone for the insurance subscriber
SubscriberTertiaryPhoneExtension String The tertiary phone extension for the insurance subscriber
SubscriberBirthDate DateTime? The birth date of the insurance subscriber
SubscriberGender String The gender of the insurance subscriber
SubscriberSSN String Social security number of the insurance subscriber
SubscriberStreet1 String The street address 1 of the insurance subscriber
SubscriberStreet2 String The street address 2 of the insurance subscriber
SubscriberCity String The city address of the insurance subscriber
SubscriberState String The state address of the insurance subscriber
SubscriberZipCode String The zipcode address of the insurance subscriber
SubscriberCountry String The country address of the insurance subscriber
NameOfEmployer String Patient’s employer name
EmployerNotes String The note related to the patient’s employer
CopayType String The type of copay for an insurance plan whether fixed or percentage
CopayAmount Decimal? The amount that is charged as copay
IsEligibleForCoverage Boolean? Eligibility for the patient’s insurance coverage
IsEligibilityNotAvailable Boolean? True when insurance eligibility is not available
EligibilityRejectReason String The reason for insurance eligibility rejection
EligibilityNotAvailableReason String The reason for insurance eligibility not available
EligibilityLastCheckedDateTimeUtc DateTime? UTC date and time a patient’s eligibility was last checked
LastModifiedByProfileGuid Guid Unique Identifier for a profile that last modified insurance plan
LastModifiedDateTimeUtc DateTime UTC date and time a patient insurance plan was last modified