|
Name |
Type |
Discontinued? |
|
1 |
PAT_ID |
VARCHAR |
No |
|
|
|
Unique patient ID associated with the Coordination of Benefits (COB) information. |
|
|
2 |
LINE |
INTEGER |
No |
|
|
|
Line number of Coordination of Benefits (COB) information on patient. |
|
|
3 |
COB_INS_CO_NAME |
VARCHAR |
No |
|
|
|
Name of the insurance company for Coordination of Benefits (COB) information. |
|
|
4 |
COB_INS_CO_ADDR |
VARCHAR |
No |
|
|
|
Address of insurance company for Coordination of Benefits (COB) information. |
|
|
5 |
COB_INSURED_NAME |
VARCHAR |
No |
|
|
|
Name of subscriber on Coordination of Benefits (COB) coverage. |
|
|
6 |
COB_GRP_POLICY_NUM |
VARCHAR |
No |
|
|
|
Group/policy number on Coordination of Benefits (COB) coverage. |
|
|
7 |
COB_GRP_NAME_EMPR |
VARCHAR |
No |
|
|
|
Group/employer name on Coordination of Benefits (COB) coverage. |
|
|
8 |
COB_STATUS_C_NAME |
VARCHAR |
No |
|
|
|
Status of information for a member/Coordination of Benefits (COB) coverage. |
May contain organization-specific values: Yes |
|
|
9 |
COB_INS_PHONE |
VARCHAR |
No |
|
|
|
Phone number of contact at Coordination of Benefits (COB) insurance company. |
|
|
10 |
COB_INS_CONTACT |
VARCHAR |
No |
|
|
|
Contact at Coordination of Benefits (COB) insurance company. |
|
|
11 |
COB_INSURED_DOB |
DATETIME |
No |
|
|
|
Date of birth for subscriber on a Coordination of Benefits (COB) coverage. |
|
|
12 |
COB_MEM_RELX_C_NAME |
VARCHAR |
No |
|
|
|
Relationship of member to the subscriber on a Coordination of Benefits (COB) coverage. |
May contain organization-specific values: Yes |
Category Entries: |
Self |
Spouse |
Child |
Employee |
Unknown |
|
|
13 |
COB_MEM_EFF_DATE |
DATETIME |
No |
|
|
|
Effective date of member on a Coordination of Benefits (COB) coverage. |
|
|
14 |
COB_MEM_TERM_DATE |
DATETIME |
No |
|
|
|
Termination date for a member on a Coordination of Benefits (COB) coverage. |
|
|
15 |
COB_MEM_COMMENT |
VARCHAR |
No |
|
|
|
Free-text comment for a member on a Coordination of Benefits (COB) coverage (member-level). |
|
|
16 |
COB_COMMENT |
VARCHAR |
No |
|
|
|
Free-text comment associated with a Coordination of Benefits (COB) coverage (coverage-level). |
|
|
17 |
COB_MEM_PRI_YN |
VARCHAR |
No |
|
|
|
Indicates if the Coordination of Benefits (COB) coverage should be considered primary for the member (Y=COB coverage is primary, N=COB coverage is not primary). |
May contain organization-specific values: No |
Category Entries: |
Primary |
Unknown |
Secondary |
Tertiary |
|
|
18 |
COB_MEMBERS |
VARCHAR |
No |
|
|
|
Returns internal member IDs associated with Coordination of Benefits (COB) coverage. |
|
|
19 |
COB_PART_D_RX_BIN |
VARCHAR |
No |
|
|
|
The Beneficiary Identification Number (BIN) used for Part D Coordination of Benefits |
|
|
20 |
COB_PART_D_RX_PCN |
VARCHAR |
No |
|
|
|
The Processor Control Number (PCN) used for Part D Coordination of Benefits |
|
|
21 |
COB_PART_D_RX_GRP |
VARCHAR |
No |
|
|
|
The group used for Part D Coordination of Benefits |
|
|
22 |
COB_PART_D_RX_ID |
VARCHAR |
No |
|
|
|
The ID used for Part D Coordination of Benefits |
|
|
23 |
COB_COVERAGE_ID |
NUMERIC |
No |
|
|
|
The ID of the indemnity coverage that is associated with this Coordination of Benefits (COB) coverage. |
|
|
24 |
COB_SUB_EMPLOYMENT_STATUS_C_NAME |
VARCHAR |
No |
|
|
|
The employment status of the subscriber on this Coordination of Benefits (COB) coverage. |
May contain organization-specific values: Yes |
Category Entries: |
Full Time |
Part Time |
Not Employed |
Self Employed |
Retired |
On Active Military Duty |
Student - Full Time |
Student - Part Time |
Unknown |
|
|
25 |
COB_MEM_COURT_DECREE_C_NAME |
VARCHAR |
No |
|
|
|
The court decree for the member on this Coordination of Benefits (COB) coverage. |
May contain organization-specific values: Yes |
Category Entries: |
Not Applicable (no court decree concerning healthcare expenses) |
Subscriber is the parent responsible for healthcare expenses |
Subscriber is the spouse of the parent responsible for healthcare expenses |
Subscriber is a parent jointly responsible for healthcare expenses |
Subscriber is the spouse of a parent jointly responsible for healthcare expenses |
Subscriber is the parent not responsible for healthcare expenses |
Subscriber is the spouse of the parent not responsible for healthcare expenses |
|
|
26 |
COB_MEM_SUB_CUSTODY_C_NAME |
VARCHAR |
No |
|
|
|
The subscriber custody for the member on this Coordination of Benefits (COB) coverage. |
May contain organization-specific values: Yes |
Category Entries: |
Not Applicable (parents married, widowed parent, etc) |
Subscriber is the custodial parent |
Subscriber is a joint custody parent |
Subscriber is the spouse of the custodial parent |
Subscriber is the spouse of a joint custody parent |
Subscriber is the non-custodial parent |
Subscriber is the spouse of the non-custodial parent |
|
|
27 |
COB_SUBSCRIBER_NUM |
VARCHAR |
No |
|
|
|
The identifier for Coordination of Benefits (COB) coverages that is shared by all members on the same coverage. |
|
|
28 |
COB_MEMBER_NUM |
VARCHAR |
No |
|
|
|
Coordination of Benefits (COB) member identification number. |
|
|