Claims

The exact timestamp when a prior authorization request was first entered into the utilization management system, used to measure turnaround compliance, track urgent versus standard review timelines, and support regulatory reporting on authorization response times.

The kidney function marker for a service pre-approval. Used in healthcare data management and clinical workflows. This field is commonly used in electronic health records (EHR), healthcare information systems (HIS), and clinical data warehouses for authorization management and reporting.

Business date for authorization within Utilization processes in Healthcare implementations. Used for reporting, integrations, and downstream analytics.

The combined date and time value marking a specific event within a prior authorization workflow—such as submission, approval, or denial—in utilization management, EHR, and payer systems. Used by data engineers for precise event sequencing, SLA measurement, and building time-series authorization analytics across claims and care management platforms.

The Drug Enforcement Administration registration number associated with a prior authorization request for controlled substances, used to verify prescriber authority to prescribe scheduled drugs and ensure compliance with federal and state pharmacy benefit regulations.

The recorded date of member death associated with an active or pending prior authorization record in payer, EHR, or utilization management systems. Used by data engineers to terminate open authorizations, suppress downstream claims processing, and ensure accurate member lifecycle management in enrollment and adjudication pipelines.

The dollar value of the member's deductible obligation applied to an authorized service at the time of prior authorization review, used in cost-sharing calculations to inform members and providers of expected out-of-pocket liability before services are rendered.

The calendar date on which a prior authorization record was logically removed or voided from the utilization management system, retained for audit history, regulatory review, and to prevent duplicate authorization submissions for the same service request.

A binary flag designating that a prior authorization record has been voided, withdrawn, or logically removed from active processing in the utilization management system, preventing the deleted authorization from being applied to claims adjudication or benefit calculations.

A human-readable text field describing the nature, scope, or clinical purpose of a prior authorization in payer, EHR, and utilization management systems. Used by data engineers to populate authorization catalogs, support search and filtering in analytics platforms, and map authorization types to service categories in claims processing pipelines.

Granular clinical and administrative information associated with a prior authorization record in utilization management, EHR, and payer adjudication systems, including service codes, units approved, and clinical criteria. Used by data engineers to build detailed authorization datasets supporting care management workflows, claims validation, and utilization reporting pipelines.

The deadline by which a utilization management decision must be rendered on a prior authorization request, driven by regulatory turnaround requirements that differ for urgent, standard, and retrospective reviews under state and federal managed care guidelines.

The total approved length of time a prior authorization remains valid for the specified service or treatment, defining the window during which associated claims will be adjudicated against the authorization without requiring a new utilization review submission.

The electronic mail address associated with a provider, reviewer, or care manager contact within a prior authorization record in utilization management and payer systems. Used by data engineers to enable automated status notifications, populate provider communication workflows, and support contact data quality audits across EHR and payer platforms.

The final date through which services are approved under a prior authorization in payer, EHR, PBM, and utilization management systems. Used by data engineers to enforce authorization validity windows during claims adjudication, trigger renewal workflows, and calculate authorization duration metrics in utilization analytics and reporting pipelines.

The precise time of day marking the expiration of an authorized service window within the utilization management system, used for inpatient and time-sensitive outpatient authorizations where hour-level granularity is required beyond a standard end date.

The identifier of the staff member or system user who manually keyed the prior authorization request into the utilization management platform, which may differ from the creating user when intake staff transcribe faxed or telephoned authorization submissions.

The member's self-reported ethnic background captured at the time of prior authorization submission, used to support health equity reporting, identify disparities in authorization approval rates across populations, and meet HEDIS and regulatory demographic data requirements.

The date after which a prior authorization is no longer valid for claims adjudication or service delivery in payer, EHR, PBM, and utilization management systems. Used by data engineers to enforce expiration logic in claims validation, trigger prior authorization renewal alerts, and manage authorization lifecycle tracking in downstream analytics pipelines.

A reference number assigned by an external system, trading partner, or referring provider organization to the prior authorization request, enabling cross-system tracking and reconciliation between health plan utilization management platforms and hospital or provider EHR systems.