Coverage data model

Updated:

View field support, webhooks, and list parameters for each integration on the Supported Integrations page.

FieldTypeRequiredDescription
idstringNoUnique identifier for the coverage
created_atstring (date-time)NoWhen the coverage record was created (ISO-8601 / YYYY-MM-DDTHH:MM:SSZ format)
updated_atstring (date-time)NoWhen the coverage record was last updated (ISO-8601 / YYYY-MM-DDTHH:MM:SSZ format)
patient_idstringNoThe patient covered by the insurance (beneficiary)
statusenumNoStatus of the coverage Values: ACTIVE, CANCELLED, DRAFT, ENTERED_IN_ERROR, OTHER
codesHealthcareCode[]NoCodings for the type of coverage (e.g. Medicare, commercial PPO)
codes[].systemstringNoThe code system URI (e.g. http://loinc.org, http://snomed.info/sct)
codes[].codestringNoThe code within the system
codes[].displaystringNoHuman-readable display text for the code
payer_namestringNoName of the insurer or payer
plan_namestringNoName of the insurance plan
group_namestringNoName of the employer group or plan group
group_identifierstringNoGroup number of the plan (reference to HrisGroup)
member_identifierstringNoMember/subscriber number on the insurance card
subscriber_namestringNoName of the policy holder
relationshipenumNoRelationship of the patient to the policy holder Values: SELF, SPOUSE, CHILD, OTHER
prioritynumberNoOrder in which the coverage is applied (1 = primary)
start_atstring (date-time)NoWhen the coverage starts (ISO-8601 / YYYY-MM-DDTHH:MM:SSZ format)
end_atstring (date-time)NoWhen the coverage ends (ISO-8601 / YYYY-MM-DDTHH:MM:SSZ format)
identifiersHealthcareIdentifier[]NoBusiness identifiers for the coverage
identifiers[].valuestringYesThe identifier value
identifiers[].typeenumNoThe kind of identifier Values: MRN, NPI, SSN, DRIVERS_LICENSE, PASSPORT, INSURANCE, OTHER
identifiers[].systemstringNoThe namespace/system URI that issued the identifier
metadataHealthcareMetadata[]NoCustom field values
metadata[].idstringNoIdentifier of the custom field
metadata[].valueobjectNoThe custom field value
metadata[].namespacestringNoThe scope or origin of the custom field
metadata[].formatenumNoThe data type of the value Values: TEXT, NUMBER, DATE, BOOLEAN, ARRAY, OBJECT
metadata[].extra_dataobjectNoAdditional data about the custom field
metadata[].slugstringNoThe custom field key

TypeScript

TypeScript
export type HealthcareCoverage = {
	id?: string; // Unique identifier for the coverage
	created_at?: string-time; // When the coverage record was created (ISO-8601 / YYYY-MM-DDTHH:MM:SSZ format)
	updated_at?: string-time; // When the coverage record was last updated (ISO-8601 / YYYY-MM-DDTHH:MM:SSZ format)
	patient_id?: string; // The patient covered by the insurance (beneficiary)
	status?: 'ACTIVE' | 'CANCELLED' | 'DRAFT' | 'ENTERED_IN_ERROR' | 'OTHER'; // Status of the coverage
	codes?: []; // Codings for the type of coverage (e.g. Medicare, commercial PPO)
	payer_name?: string; // Name of the insurer or payer
	plan_name?: string; // Name of the insurance plan
	group_name?: string; // Name of the employer group or plan group
	group_identifier?: string; // Group number of the plan (reference to HrisGroup)
	member_identifier?: string; // Member/subscriber number on the insurance card
	subscriber_name?: string; // Name of the policy holder
	relationship?: 'SELF' | 'SPOUSE' | 'CHILD' | 'OTHER'; // Relationship of the patient to the policy holder
	priority?: number; // Order in which the coverage is applied (1 = primary)
	start_at?: string-time; // When the coverage starts (ISO-8601 / YYYY-MM-DDTHH:MM:SSZ format)
	end_at?: string-time; // When the coverage ends (ISO-8601 / YYYY-MM-DDTHH:MM:SSZ format)
	identifiers?: []; // Business identifiers for the coverage
	metadata?: []; // Custom field values
	raw?: any; // Raw data from integration
} 

Zod

Zod
import { z } from 'zod';

export const ZodHealthcareCoverage = z.object({
	id: z.string().optional().describe("Unique identifier for the coverage"),
	created_at: z.string-time().optional().describe("When the coverage record was created (ISO-8601 / YYYY-MM-DDTHH:MM:SSZ format)"),
	updated_at: z.string-time().optional().describe("When the coverage record was last updated (ISO-8601 / YYYY-MM-DDTHH:MM:SSZ format)"),
	patient_id: z.string().optional().describe("The patient covered by the insurance (beneficiary)"),
	status: z.enum("ACTIVE", "CANCELLED", "DRAFT", "ENTERED_IN_ERROR", "OTHER").optional().describe("Status of the coverage"),
	codes: z.array().optional().describe("Codings for the type of coverage (e.g. Medicare, commercial PPO)"),
	payer_name: z.string().optional().describe("Name of the insurer or payer"),
	plan_name: z.string().optional().describe("Name of the insurance plan"),
	group_name: z.string().optional().describe("Name of the employer group or plan group"),
	group_identifier: z.string().optional().describe("Group number of the plan (reference to HrisGroup)"),
	member_identifier: z.string().optional().describe("Member/subscriber number on the insurance card"),
	subscriber_name: z.string().optional().describe("Name of the policy holder"),
	relationship: z.enum("SELF", "SPOUSE", "CHILD", "OTHER").optional().describe("Relationship of the patient to the policy holder"),
	priority: z.number().optional().describe("Order in which the coverage is applied (1 = primary)"),
	start_at: z.string-time().optional().describe("When the coverage starts (ISO-8601 / YYYY-MM-DDTHH:MM:SSZ format)"),
	end_at: z.string-time().optional().describe("When the coverage ends (ISO-8601 / YYYY-MM-DDTHH:MM:SSZ format)"),
	identifiers: z.array().optional().describe("Business identifiers for the coverage"),
	metadata: z.array().optional().describe("Custom field values"),

});

Python

Python
import dataclasses

@dataclasses.dataclass
class HealthcareCoverageStatus(str, Enum):
	ACTIVE = 'ACTIVE'
	CANCELLED = 'CANCELLED'
	DRAFT = 'DRAFT'
	ENTERED_IN_ERROR = 'ENTERED_IN_ERROR'
	OTHER = 'OTHER'

@dataclasses.dataclass
class HealthcareCoverageRelationship(str, Enum):
	SELF = 'SELF'
	SPOUSE = 'SPOUSE'
	CHILD = 'CHILD'
	OTHER = 'OTHER'

@dataclasses.dataclass
class HealthcareCoverage:
	"""Unique identifier for the coverage"""
	id: Optional[str]
	"""When the coverage record was created (ISO-8601 / YYYY-MM-DDTHH:MM:SSZ format)"""
	created_at: Optional[str]
	"""When the coverage record was last updated (ISO-8601 / YYYY-MM-DDTHH:MM:SSZ format)"""
	updated_at: Optional[str]
	"""The patient covered by the insurance (beneficiary)"""
	patient_id: Optional[str]
	"""Status of the coverage"""
	status: Optional[HealthcareCoverageStatus]
	"""Codings for the type of coverage (e.g. Medicare, commercial PPO)"""
	codes: Optional[PropertyHealthcareCoverageCodes]
	"""Name of the insurer or payer"""
	payer_name: Optional[str]
	"""Name of the insurance plan"""
	plan_name: Optional[str]
	"""Name of the employer group or plan group"""
	group_name: Optional[str]
	"""Group number of the plan (reference to HrisGroup)"""
	group_identifier: Optional[str]
	"""Member/subscriber number on the insurance card"""
	member_identifier: Optional[str]
	"""Name of the policy holder"""
	subscriber_name: Optional[str]
	"""Relationship of the patient to the policy holder"""
	relationship: Optional[HealthcareCoverageRelationship]
	"""Order in which the coverage is applied (1 = primary)"""
	priority: Optional[int]
	"""When the coverage starts (ISO-8601 / YYYY-MM-DDTHH:MM:SSZ format)"""
	start_at: Optional[str]
	"""When the coverage ends (ISO-8601 / YYYY-MM-DDTHH:MM:SSZ format)"""
	end_at: Optional[str]
	"""Business identifiers for the coverage"""
	identifiers: Optional[PropertyHealthcareCoverageIdentifiers]
	"""Custom field values"""
	metadata: Optional[PropertyHealthcareCoverageMetadata]
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