Insurance Benefit Details
Source Object: Insurance Benefit Details
Overview and Usage: The "Insurance Benefit Details" source object in athena EHR contains essential information related to insurance benefits and coverage. It's a valuable resource for managing patient insurance information and understanding the specifics of healthcare coverage. Here's a brief overview of its key fields and their usage:
- ANSI 271: Contains data from ANSI 271 transactions, which are standard electronic responses from insurance providers regarding eligibility, benefits, and coverage.
- Date of Service: Records the date on which healthcare services were provided or scheduled.
- Last Check Date: Indicates the most recent date on which the benefit information was verified or checked.
- Service Type Code: Specifies the code for the type of healthcare service or procedure covered by the insurance.
The "Insurance Benefit Details" source object serves as a vital reference for both healthcare providers and patients. It helps ensure that services are appropriately covered by insurance plans, reducing billing errors and improving cost transparency. Developers can utilize this source object to build applications that facilitate insurance verification and streamline billing processes.
Mapping Table
Data Field | Example Value | Source Data Field Description | Source Field Data Type | Source Data Field Cardinality | Mapped FHIR++ Resource | Mapped FHIR Data Field | Augmented Mapping | Associated Coding System | Associated FHIR Data Field Extension | Mapping Context |
---|---|---|---|---|---|---|---|---|---|---|
ansi271 | - | 271 data from the payer. | string | 0..1 | CoverageEligibilityResponse | extension.valueString | ansi-271 | Top Level | ||
dateofservice | - | Date on which eligibility was checked. | string | 0..1 | CoverageEligibilityResponse | servicedDate | Top Level | |||
lastcheckdate | - | The last time we did an eligibilty check for this patient. | string | 0..1 | CoverageEligibilityResponse | event.whenDateTime | type=last-checked,system=athena | Top Level | ||
servicetypecode | - | STC Code for which we are checking the eligibility. | string | 0..1 | CoverageEligibilityRequest | extension.valueString | service-type-code | Top Level | ||
dateofservice | - | Date on which eligibility was checked. | string | 0..1 | CoverageEligibilityRequest | servicedDate | Top Level |