Domain
Member
Enrollment, eligibility, demographics and plan attribution
2,833 member terms
The enterprise master patient index identifier that uniquely represents a patient across all systems within a health network. Assigned through an EMPI process to resolve duplicate records and link patient data from disparate clinical, billing, and enrollment systems into a single longitudinal patient identity.
The upper threshold value established for a patient-specific clinical or administrative parameter, such as a maximum allowable medication dose, benefit limit, or authorization quantity. Referenced in clinical decision support, pharmacy benefit management, and utilization management to enforce safety and coverage boundaries.
The unique identifier assigned to a patient by a healthcare facility to track their medical record within that organization's EHR or HIS. Used to retrieve clinical documentation, link encounters, and coordinate care across departments, and is distinct from enterprise-level identifiers used across health system networks.
The middle name or initial of a patient as recorded in their demographic profile. Used in full name construction, identity verification, and patient matching processes where middle name data helps disambiguate patients who share the same first and last name within clinical, enrollment, or claims systems.
The lower threshold value established for a patient-specific clinical or administrative parameter, such as a minimum required medication dose, authorization quantity, or coverage floor. Used in clinical decision support, pharmacy benefit management, and care protocols to enforce safety guidelines and benefit eligibility rules.
The mobile or cellular phone number recorded for a patient in their demographic contact profile. Used by care teams, appointment scheduling systems, telehealth platforms, and patient engagement tools to send appointment reminders, care gap alerts, and secure clinical communications via SMS or voice outreach.
The username or system identifier of the user or process that last updated a patient's demographic or clinical record. Captured in audit trail logs across EHR and data warehouse systems to support data governance, change history tracking, and compliance with regulatory requirements for record integrity.
The timestamp recording the most recent update to a patient demographic or clinical record in EHR, claims, or enrollment systems. Critical for data engineers implementing incremental data loads, change data capture pipelines, and audit trail processes across healthcare platforms.
The date and timestamp recording when a patient's demographic or clinical record was most recently updated. Stored in EHR and data warehouse audit columns to support incremental data loads, change data capture processes, and regulatory audit trails that require documentation of when record modifications occurred.
The legal or display name of a patient as stored in provider EHR and practice management systems, typically including first, middle, and last name fields. Used in reporting, identity matching, and downstream integrations requiring patient-level data linkage across healthcare data pipelines.
Free-text or structured annotation recorded by a clinician or care team member within an EHR system, capturing clinical observations, progress notes, or care coordination details. Data engineers use this field for NLP pipelines, clinical analytics, and longitudinal patient record assembly.
A unique numeric reference identifier assigned to a patient within eligibility and enrollment systems, used to link member records across payer, provider, and PBM platforms. Essential for data engineers performing patient-level joins, deduplication, and cross-system identity resolution in healthcare data pipelines.
The date on which a patient's symptoms or condition first appeared, as documented in clinical records. Used in diagnosis coding, chronic disease tracking, and insurance claims to establish the timeline of illness onset relative to treatment and coverage eligibility.
The dollar amount paid out-of-pocket by the patient for a healthcare service, including copayments, coinsurance, and deductible contributions. Captured on claims and remittance records to reconcile patient financial responsibility after insurance adjudication.
The date on which a patient's out-of-pocket payment was received and applied to a medical claim or account balance. Used in revenue cycle management to track payment timelines, reconcile accounts receivable, and report collection activity against service dates.
The hierarchical relationship identifier linking a patient record to a superior or guardian entity within EHR and enrollment systems. Used by data engineers to model family unit structures, dependent relationships, and subscriber-to-patient hierarchies in healthcare data schemas.
The dollar value of a financial transaction made by a patient toward medical services rendered, including installment plan payments, copay collections, or balance-due settlements. Used in billing systems to update account balances and generate patient financial statements.
The current processing state of a patient's financial obligation, such as pending, partial, paid in full, or delinquent. Used in revenue cycle and billing systems to prioritize collections activity, trigger statements, and report on accounts receivable aging.
A percentage metric representing a patient-level ratio within compliance and quality reporting systems, such as medication adherence rate or care gap closure percentage. Used by data engineers in population health analytics and compliance dashboards to measure patient performance against defined benchmarks.
The defined time span associated with a patient's enrollment, treatment, or measurement window in EHR, claims, and eligibility systems. Data engineers use this field to scope longitudinal analyses, define cohort windows, and align patient data across plan years or care episodes.