CoverageBenefitItem

Specific service covered by the insurance plan. This object is available in API version 53.0 and later.

Supported Calls

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

Fields

Field	Details
BenefitCategory	Type string Properties Create, Filter, Group, Nillable, Sort, Update Description Name of the category this benefit is in.
CodeSetServiceTypeId	Type reference Properties Create, Filter, Group, Nillable, Sort, Update Description ID of a Code Set Service Type in the Code Set object. This is a relationship field. Relationship Name CodeSetServiceType Relationship Type Lookup Refers To CodeSet
CoverageBenefitId	Type reference Properties Create, Filter, Group, Sort Description The ID of the covered benefit this item belongs to. This is a relationship field. Relationship Name CoverageBenefit Relationship Type Lookup Refers To CoverageBenefit
CoverageLevel	Type string Properties Create, Filter, Group, Nillable, Sort, Update Description Description of the level of coverage provided by this item.
DoesDeductibleApply	Type boolean Properties Create, Defaulted on create, Filter, Group, Sort, Update Description Specifies whether the benefit item requires a prior expenditure by the patient. The default value is 'false'.
InNetworkCoverage	Type textarea Properties Create, Nillable, Update Description Description of the in network coverage provided by this item.
IsActive	Type boolean Properties Create, Defaulted on create, Filter, Group, Sort, Update Description Specifies whether the benefit item is currently available. The default value is 'false'.
IsInPlanNetwork	Type boolean Properties Create, Defaulted on create, Filter, Group, Sort, Update Description Indicates if the benefit is only available in the plan network. The default value is 'false'.
IsPreauthorizationRequired	Type boolean Properties Create, Defaulted on create, Filter, Group, Sort, Update Description Specifies whether the service must be approved before use. The default value is 'false'.
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.
MemberId	Type reference Properties Create, Filter, Group, Nillable, Sort, Update Description The ID of the member receiving this benefit item. This is a relationship field. Relationship Name Member Relationship Type Lookup Refers To Account
Name	Type string Properties Create, Filter, Group, idLookup, Sort, Update Description Name of this coverage benefit item.
Notes	Type textarea Properties Create, Nillable, Update Description Additional information about this coverage benefit item.
OutofNetworkCoverage	Type textarea Properties Create, Nillable, Update Description Description of the coverage for 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. This is a polymorphic relationship field. Relationship Name Owner Relationship Type Lookup Refers To Group, User
ServiceType	Type string Properties Create, Filter, Group, Nillable, Sort, Update Description The type of service this plan benefit item provides.
ServiceTypeCode	Type string Properties Create, Filter, Group, Nillable, Sort, Update Description The code for the type of service this plan benefit item provides.
SourceSystem	Type string Properties Create, Filter, Group, Nillable, Sort, Update Description The name of the system this coverage benefits item record came from.
SourceSystemIdentifier	Type string Properties Create, Filter, Group, Nillable, Sort, Update Description The identifier of the CoverageBenefitItem in its source system.
SourceSystemModified	Type dateTime Properties Create, Filter, Nillable, Sort, Update Description The ID of this coverage benefits item record on its source system.
SourceSystemModified	Type dateTime Properties Create, Filter, Nillable, Sort, Update Description The date on which this coverage benefits item was last changed on the source system.
TimePeriod	Type string Properties Create, Filter, Group, Nillable, Sort, Update Description A description of the period this plan benefit item covers.

Associated Objects

This object has the following associated objects. If the API version isn’t specified, they’re available in the same API versions as this object. Otherwise, they’re available in the specified API version and later.

CoverageBenefitItemChangeEvent (API version 59.0): Change events are available for the object.

Salesforce Health Cloud Developer Guide

CoverageBenefitItem

Supported Calls

Fields

Associated Objects