Insurance Eligibility Usage
Insurance Eligibility Usage
Source Object: Insurance Eligibility Usage
The Insurance Eligibility Usage source object is designed to provide insights into the utilization of a patient's insurance eligibility. It tracks the usage of insurance benefits over time and is a valuable tool for managing patient insurance coverage efficiently.
Overview
Insurance eligibility is a dynamic aspect of healthcare, and it's crucial to monitor how and when patients utilize their insurance benefits. The Insurance Eligibility Usage source object is a complementary component to the Insurance Eligibility source object, providing historical context regarding the use of insurance benefits.
Usage
The Insurance Eligibility Usage source object serves several purposes:
- Eligibility Usage Tracking: It tracks the utilization of insurance benefits, such as the number of visits, procedures, or services covered during a specific period.
- Start and End Dates: The start and end dates indicate the period during which the insurance benefits were used, allowing for precise tracking and reporting.
- Practice Identification: Associates eligibility usage data with specific healthcare practices, which is essential for multi-practice healthcare platforms.
By utilizing the Insurance Eligibility Usage source object, healthcare administrators can gain insights into how insurance benefits are utilized by patients. This information is vital for optimizing patient care, ensuring proper billing, and managing insurance claims effectively. It also helps in understanding patterns of healthcare utilization, which can be valuable for strategic planning and resource allocation.
Mapping Table
| Data Field | Source Field Data Type | Resource Mapping Context | Source Data Field Cardinality | Source Data Field Description | Example Value | Source Data Field Validation Rule | Mapped FHIR Resource | Mapped FHIR Data Field | Augmented Mapping | Associated Coding System | Associated FHIR Data Field Extension | Mapped FHIR Data Field Type |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| eligibility_usage_counter | Integer | Top Level | 0..1 | The number of insurance eligibilities requested by the practice in period between start_date and end_date | 4 | - | CoverageEligibilityResponse | extension[*].valueInteger | - | NA | elgibility-usage-counter | TBD |
| end_date | Date | Top Level | 0..1 | The end date (inclusive) of the time period for insurance eligibility usage. YYYY-MM-DD | 2022-07-28 | - | CoverageEligibilityResponse | servicedPeriod.end | - | NA | - | TBD |
| practice_id | Long | Top Level | 0..1 | The id of the practice | 123456 | - | CoverageEligibilityResponse | requestor.reference | Organization | NA | - | TBD |
| start_date | Date | Top Level | 0..1 | The start date (inclusive) of the time period for insurance eligibility usage. YYYY-MM-DD | 1970-08-23 | - | CoverageEligibilityResponse | servicedPeriod.start | - | NA | - | TBD |