Superbill Insurances

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