Member plan table
The Member Plan [sn_hcls_member_plan] table stores the details of a health insurance plan associated with a patient.
Key features
- Extends the Install base item [sn_install_base_item] table to store member plan details.
- Models the health insurance data associated with a patient, including the member number, group number, the payer plan that is purchased and start and end dates of the plan.
Role required to configure the table: sn_hcls.admin.
For more information, see Healthcare and Life Sciences data model.
| Field | Data type | Description |
|---|---|---|
| Effective from | Date | Start date from when the member plan is effective. |
| Effective to | Date | End date until when the member plan is effective. |
| External identifier | String | Identifier of the record in an electronic medical record \(EMR\) system. |
| Group number | String | Group number or policy number of the member. |
| Member | Reference | The associated member's first and last name. |
| Member number | String | Unique ID number of the patient that enables healthcare providers to verify insurance coverage and arrange payment for services. |
| Number | String | Alpha-numeric profile identifier of the member plan. |
| Patient | Reference | Name of the patient in whose name is the plan. |
| Plan priority | String | Priority of the plan. The priority of the plan is:
|
| Payer plan | Reference | Member plan taken by the patient. |
| Relation to subscriber | Reference | Relationship of the dependent member with the subscriber. |
| Rx Bin | String | Number to identify how a prescription drug will be reimbursed and where a pharmacy can send a reimbursement claim to. |
| Rx Group | String | Alphanumeric or numeric value of the member plan that is used to process prescription benefits. |
| Rx PCN | String | Processor control number \(PCN\) used in routing of pharmacy reimbursements. |
| Source | Reference | Source system details of an external healthcare system in a ServiceNow instance. |
| Subscriber | Reference | Subscriber's patient record. |
Parent Topic:Healthcare and Life Sciences data model tables