Domain
Enrollment, eligibility, demographics and plan attribution
2,833 member terms
The telephone contact number stored for a patient within EHR, member enrollment, and care management systems, including home, mobile, and work phone fields. Used by data engineers in patient outreach workflows, contact data quality assessments, and communication preference routing pipelines.
The documented clinical treatment plan outlining a patient's care goals, interventions, medications, and follow-up actions as determined by the treating clinician. Recorded in EHR encounter notes and used to coordinate ongoing care across providers and care settings.
The unique alphanumeric identifier assigned by a health insurance payer to a patient's insurance policy or group coverage. Used in claims submission, eligibility verification, and member enrollment systems to link a patient to their specific insurance benefit plan.
The name by which a patient prefers to be addressed, which may differ from their legal name as recorded on insurance or identification documents. Captured in EHR demographic records to support respectful, patient-centered communication across clinical encounters.
A reference to the prior version of a patient record in a healthcare data system. Used in clinical data management to track historical changes to patient demographics, diagnoses, and care team assignments. Supports longitudinal patient analysis and audit trail requirements in clinical data warehouses.
The cost amount assigned to a medical service, procedure, or item that is billable or estimated for a specific patient, factoring in applicable insurance adjustments, discounts, or self-pay rates. Used in billing and revenue cycle systems to generate patient-facing cost estimates.
A flag designating whether a patient is the primary insured member on a health plan, as opposed to a dependent or secondary beneficiary. Used in member enrollment and claims processing to determine coordination of benefits rules and billing responsibility.
An importance or urgency ranking assigned to a patient within care management, scheduling, or triage systems, indicating the order or level of clinical attention required. Data engineers use this attribute to build prioritized worklists, escalation logic, and population stratification models in healthcare platforms.
The calendar date on which a medical procedure, surgery, or clinical intervention was performed on the patient. Recorded on medical claims and in clinical systems to establish the service date used for billing, authorization validation, and outcomes tracking.
A measured numeric quantity associated with a patient record within pharmacy and clinical systems, such as days supply, dispensed units, or dosage amounts. Used by data engineers to calculate medication utilization metrics, validate pharmacy claims data, and support PBM analytics pipelines.
The racial category self-reported or recorded for a patient, based on standard classifications such as OMB categories. Captured in clinical and enrollment systems to support population health reporting, health equity analysis, and federally mandated demographic data collection.
The defined minimum and maximum value boundaries for a patient-level clinical or operational metric, such as lab result reference ranges or dosage thresholds in EHR systems. Data engineers use this field for data validation rules, clinical alerting logic, and outlier detection in healthcare datasets.
An applied rate value associated with a patient record within eligibility and premium billing systems, such as a premium rate, copay rate, or utilization rate. Used by data engineers to calculate patient-level cost allocations, actuarial analytics, and financial reporting in healthcare data warehouses.
A scored assessment value assigned to a patient based on clinical, behavioral, or satisfaction criteria, such as a patient-reported outcome score, satisfaction survey result, or acuity rating. Used in quality measurement and care management programs to stratify and monitor patient populations.
A calculated proportional value relating a patient-level metric to a broader benchmark or population measure, such as a nurse-to-patient staffing ratio or a patient's lab result relative to a normal reference range. Used in quality reporting and operational analytics.
A coded or descriptive reason field associated with a patient-level event in eligibility and claims systems, such as a reason for termination, denial, or referral. Used by data engineers in root cause analysis, workflow automation, and audit reporting across healthcare data platforms.
The date on which a patient record, referral, authorization request, or clinical document was received by a facility, department, or health plan. Used in operational workflows to measure response times, track intake processing, and monitor service level compliance.
An external pointer or cross-system identifier linking a patient record to a related entity in EHR, claims, or interoperability systems, such as an NPI, MRN, or payer-assigned ID. Critical for data engineers performing patient identity resolution, master data management, and cross-platform record linkage in healthcare pipelines.
The date on which a patient's medical condition, complaint, or care issue was documented as resolved or closed. Used in clinical records and case management systems to calculate episode duration, measure treatment effectiveness, and close active care management cases.
The recorded outcome of a clinical test, procedure, or assessment for a patient within EHR and laboratory information systems, such as lab values, diagnostic findings, or screening outcomes. Data engineers use this field to build clinical quality measures, longitudinal outcome tracking, and population health analytics pipelines.