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healthcare-plan-details.schema.md

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Healthcare Plan Details Schema

https://ns.adobe.com/xdm/mixins/healthcare-plan-details

Patient medical plan details such as network, type, and active status.

Abstract Extensible Status Identifiable Custom Properties Additional Properties Defined In
Can be instantiated Yes Stable No Forbidden Permitted fieldgroups/plan/healthcare-plan-details.schema.json

Healthcare Plan Details Example

{}

Healthcare Plan Details Properties

Property Type Required Defined by
xdm:healthcarePlanDetails object Optional Healthcare Plan Details (this schema)
* any Additional this schema allows additional properties

xdm:healthcarePlanDetails

Healthcare Plan Details

Information about the healthcare plan.

xdm:healthcarePlanDetails

  • is optional
  • type: object
  • defined in this schema

xdm:healthcarePlanDetails Type

object with following properties:

Property Type Required
xdm:coverageType string Optional
xdm:isActive boolean Optional
xdm:lastVerificationDate string Optional
xdm:networkDetails array Optional
xdm:payerID string Optional
xdm:payerName string Optional
xdm:planLevel string Optional
xdm:planType string Optional
xdm:targetOwnerType string Optional

xdm:coverageType

Coverage Type

Plan coverage type.

xdm:coverageType

  • is optional
  • type: string
xdm:coverageType Type

string

xdm:coverageType Known Values
Value Description
medical Medical
dental Dental
vision Vision
accident Accident

xdm:isActive

Is Active

Indicates whether the plan is active.

xdm:isActive

  • is optional
  • type: boolean
xdm:isActive Type

boolean

xdm:lastVerificationDate

Last Verification Date

The date on which the plan was last verified.

xdm:lastVerificationDate

  • is optional
  • type: string
xdm:lastVerificationDate Type

string

xdm:networkDetails

Network Details

undefined

xdm:networkDetails

  • is optional
  • type: object[]
xdm:networkDetails Type

Array type: object[]

All items must be of the type: object with following properties:

Property Type Required
xdm:networkID string Optional
xdm:networkName string Optional

xdm:networkID

Network Identifier

The insurer-specific identifier for the insurer-defined network of providers to which the beneficiary may seek treatment which will be covered at the 'in-network' rate.

xdm:networkID

  • is optional
  • type: string
xdm:networkID Type

string

xdm:networkName

Network Name

The insurer-specific identifier for the insurer-defined network of providers to which the beneficiary may seek treatment which will be covered at the 'in-network' rate.

xdm:networkName

  • is optional
  • type: string
xdm:networkName Type

string

xdm:payerID

Payer ID

Unique identifier of the payer. This is the insurance provider of the plan.

xdm:payerID

  • is optional
  • type: string
xdm:payerID Type

string

xdm:payerName

Payer Name

Name of the payer. This is the insurance provider of the plan.

xdm:payerName

  • is optional
  • type: string
xdm:payerName Type

string

xdm:planLevel

Plan Level

This indicates if the plan is primary, secondary, tertiary etc.

xdm:planLevel

  • is optional
  • type: string
xdm:planLevel Type

string

xdm:planLevel Known Values
Value Description
primary Primary
secondary Secondary
tertiary Tertiary
quaternary Quaternary

xdm:planType

Plan Type

This indicates if the plan is primary, secondary or a tertiary plan.

xdm:planType

  • is optional
  • type: string
xdm:planType Type

string

xdm:planType Known Values
Value Description
hmo HMO
epo PPO
pos POS
hdhp HDHP

xdm:targetOwnerType

Target Owner Type

The type of owner a plan is for. Examples are individual, group, organization, etc.

xdm:targetOwnerType

  • is optional
  • type: string
xdm:targetOwnerType Type

string