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PlanBenefitItem

Represents the details of a benefit available under a purchaser’s plan that is offered to their members.

Supported Calls

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

Fields

BenefitCategory

  • Type: string
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: Name of the benefit category this item belongs to.

CoverageLevel

  • Type: string
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: Description of the level of coverage provided.

FrequencyType

  • Type: picklist
  • Properties: Create, Filter, Group, Nillable, Restricted picklist, Sort, Update
  • Description: The frequency type of the plan benefit item associated with the home healthcare visit.

    This field is available in API version 66.0 and later with the Home Health add-on license.

  • Possible values:
    • Daily
    • Fortnightly
    • Monthly
    • Quarterly
    • Weekly
    • Yearly

InNetworkCoverage

  • Type: currency
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The amount available to contribute towards treatment costs for each treatment undertaken by the health plan’s preferred providers.

IsInPlanNetwork

  • Type: boolean
  • Properties: Create, Defaulted on create, Filter, Group, Sort, Update
  • Description: Indicates if the benefit is only available in the plan network.

ItemCodeId

  • Type: reference
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: The code of the plan benefit item.

    This field is a polymorphic relationship field.

    This field is available in API version 64.0 and later.

  • Relationship Name: ItemCode
  • Refers To: CodeSet, CodeSetBundle

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.

Name

  • Type: string
  • Properties: Create, Filter, Group, Sort, Update
  • Description: Name of this benefit item.

Notes

  • Type: textarea
  • Properties: Create, Nillable, Update
  • Description: Additional information about this benefit item.

OutofNetworkCoverage

  • Type: currency
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The amount available to contribute towards treatment costs for each treatment undertaken by 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.

PauthRequirementEndDate

  • Type: dateTime
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The date from which preauthorization for the plan benefit item is required or not.

    This field is available in API version 64.0 and later.

PauthRequirementStartDate

  • Type: dateTime
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The last date for which preauthorization for the plan benefit item is required or not.

    This field is available in API version 64.0 and later.

PlanBenefitId

  • Type: reference
  • Properties: Create, Filter, Group, Sort
  • Description: The ID of the benefit this item belongs to.

PreauthorizationTypeCodeId

  • Type: reference
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: The code which represents the type of preauthorization that the plan benefit item requires.

    This field is a relationship field.

    This field is available in API version 64.0 and later.

  • Relationship Name: PreauthorizationTypeCode
  • Refers To: CodeSet

ServiceType

  • Type: string
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: The type of service this plan benefit item provides for.

ServiceTypeCode

  • Type: string
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: The code for the type of service this plan benefit item provides for.

SourceSystem

  • Type: string
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: The name of the system this benefits item record came from.

SourceSystemIdentifier

  • Type: string
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: The ID of this benefits item record on its source system.

SourceSystemModified

  • Type: date
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: The date on which this benefits item was last updated from the source system.

TimePeriod

  • Type: string
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: A description of the period during which services under this plan benefit item are to be rendered or continued.

Associated Objects

This object has the following associated objects. Unless noted, they are available in the same API version as this object.

PlanBenefitItemChangeEvent (API version 60.0)
Change events are available for the object.
PlanBenefitItemFeed
Feed tracking is available for the object.
PlanBenefitItemHistory
History is available for tracked fields of the object.
PlanBenefitItemOwnerSharingRule
Sharing rules are available for the object.
PlanBenefitItemShare
Sharing is available for the object.