Member

The professional license identifier associated with a provider or entity linked to a coinsurance cost-sharing record. Used in health plan credentialing and claims systems to verify that services generating coinsurance obligations were rendered by a properly licensed and credentialed healthcare professional.

The marital status of the member or subscriber associated with a coinsurance cost-sharing arrangement. Used in benefits administration to determine applicable family coinsurance rates and cost-sharing tiers within health plan benefit structures.

The enterprise-wide unique identifier assigned to a specific coinsurance cost-sharing rule or record. Enables consistent tracking and cross-referencing of coinsurance configurations across claims processing, benefits administration, and member enrollment systems.

The maximum allowable coinsurance percentage or dollar amount a member is required to pay for covered services under a health plan benefit. Once this threshold is reached, the plan typically covers remaining eligible costs at 100% for the benefit period.

The medical record number of the patient linked to a specific coinsurance cost-sharing record. Used to associate coinsurance payment obligations with clinical encounters and reconcile member cost-sharing responsibilities against patient account records.

The middle name or initial of the member or subscriber associated with a coinsurance cost-sharing record. Used in member identity verification and matching processes within benefits administration and health plan enrollment systems.

The minimum coinsurance percentage or dollar amount applicable to a covered service under a health plan benefit. Defines the floor of member cost-sharing responsibility and is used in benefits configuration and claims adjudication processing.

The mobile phone number of the member or subscriber associated with a coinsurance cost-sharing record. Used for member outreach, cost-sharing notifications, and billing communications within health plan member services operations.

The user identifier of the individual who last updated a coinsurance cost-sharing record. Supports audit trail requirements and change management tracking within benefits administration and health plan configuration systems.

The calendar date on which a coinsurance cost-sharing record was most recently updated. Used in audit logging, benefits configuration change tracking, and effective date management within health plan administration systems.

The timestamp indicating when a coinsurance cost-sharing record was most recently updated. Provides granular audit trail data for benefits configuration changes and supports sequencing of updates within health plan administration systems.

Human-readable name for coinsurance within Member processes in Healthcare implementations. Used for reporting, integrations, and downstream analytics.

A free-text annotation attached to a coinsurance cost-sharing record documenting exceptions, special conditions, or administrative context. Used by benefits administrators to capture non-structured information relevant to a coinsurance rule or member arrangement.

Reference number for coinsurance within Eligibility processes in Healthcare implementations. Used for reporting, integrations, and downstream analytics.

The effective date on which a coinsurance cost-sharing arrangement begins applying to a member's health plan benefits. Used in benefits administration to manage coinsurance applicability windows and align cost-sharing rules with plan year or enrollment period boundaries.

The recorded blood oxygen saturation level associated with a clinical encounter linked to a coinsurance cost-sharing event. Used when coinsurance records are tied to specific clinical service records requiring vital sign documentation for billing or clinical validation purposes.

The dollar amount of coinsurance actually paid by the member for a covered healthcare service. Captured during claims adjudication and payment processing to reflect the member's fulfilled cost-sharing obligation and reconcile against expected coinsurance liability.

The date on which the member's coinsurance payment was received or processed for a covered healthcare service. Used in claims payment reconciliation, member account management, and accounts receivable tracking within health plan financial systems.

The parent record or higher-level benefit configuration to which a coinsurance cost-sharing rule is subordinate. Used in hierarchical benefits plan structures to link coinsurance rules to their governing plan, benefit tier, or coverage category within health plan administration systems.

The specific percentage of an allowed healthcare service cost that a member is responsible for paying after the deductible is met. A core cost-sharing parameter used during claims adjudication to calculate member liability under medical, dental, or vision health plan benefits.