Operations

The professional state license identifier associated with a provider or administrator linked to a coverage termination transaction. Referenced in enrollment and credentialing systems to audit which licensed professional processed or authorized the disenrollment action within the health plan.

The recorded marital status of a member at the time their health plan coverage was terminated. Captured in member enrollment systems to support qualifying life event validation, dependent eligibility audits, and coordination of benefits updates triggered by divorce, separation, or spousal coverage changes.

The enterprise-wide master identifier assigned to a member coverage termination record, used to link the disenrollment event across multiple health plan systems including enrollment, claims, and care management. Supports accurate member matching and historical coverage tracking within the payer's master person index.

The upper boundary value associated with a coverage termination rule or benefit limit, such as the maximum age for dependent coverage termination or the maximum benefit period before mandatory disenrollment. Used in enrollment system logic to automate eligibility end dates based on plan rules.

The patient medical record number associated with a member at the time their health plan coverage was terminated. Used to link the disenrollment event in enrollment systems back to clinical records, ensuring continuity of care documentation and accurate coordination between the payer and treating facilities.

The middle name or initial of the subscriber or dependent member whose health plan coverage was terminated. Included in member enrollment and disenrollment records to improve identity matching accuracy when processing eligibility transactions, termination notices, and carrier 834 EDI files.

The lower boundary value associated with a coverage termination threshold or eligibility rule, such as the minimum enrollment duration required before a voluntary disenrollment is permitted. Used in member enrollment systems to enforce plan participation requirements before processing a coverage end date.

The mobile phone number on record for a member at the time their health plan coverage was terminated. Used by member enrollment and outreach systems to send SMS notifications regarding disenrollment confirmation, COBRA election deadlines, and instructions for obtaining replacement coverage.

The unique identifier of the user, system, or batch process that last updated a member coverage termination record. Captured in enrollment system audit logs to maintain accountability and traceability for changes made to disenrollment dates, termination reason codes, or member eligibility end records.

The calendar date on which a member coverage termination record was most recently updated in the enrollment or eligibility system. Used in audit trails and compliance reporting to track when changes to disenrollment data occurred, supporting retroactive adjustment processing and regulatory oversight.

The timestamp indicating the exact time a member coverage termination record was last modified in the enrollment or eligibility system. Combined with the modified date to create a precise audit trail for disenrollment changes, supporting transaction sequencing and conflict resolution in real-time eligibility environments.

The descriptive label or display name associated with a coverage termination reason code or disenrollment category in a health plan enrollment system. Used to present human-readable termination reason descriptions on member communications, internal reports, and eligibility transaction summaries.

The unique reference number assigned to a specific member coverage termination transaction within a health plan enrollment system. Used to track, retrieve, and audit individual disenrollment events across enrollment, billing, and claims systems, and referenced on termination confirmation documents sent to members and employers.

The date on which the circumstances or qualifying event that triggered a member's health plan coverage termination first occurred, such as a job loss, aging out of dependent eligibility, or loss of qualifying status. Used in enrollment systems to validate the termination effective date against plan rules and regulatory grace periods.

The peripheral oxygen saturation (SpO2) percentage recorded at the time a clinical episode, treatment authorization, or care program ends. Captured in clinical documentation to reflect the patient's respiratory status at the point of service termination or discharge.

The dollar amount paid by the health plan or payer at the time a member's coverage or claim is terminated. Used in insurance enrollment and claims processing to reconcile final financial obligations, including prorated premiums or claim settlements associated with the coverage end date.

The calendar date on which the final payment was issued in connection with a coverage termination or claim closure. Used in insurance enrollment and claims processing to track when financial settlement occurred relative to the member's or provider's coverage end date.

The higher-level entity, such as a group policy, plan sponsor, or parent enrollment record, associated with a coverage termination event. Used in member enrollment systems to link a dependent or subsidiary termination record to its controlling parent account or group contract.

A numeric ratio or percentage value associated with a coverage or benefit termination, such as the portion of a benefit period elapsed, cost-sharing percentage applied at termination, or the rate of member attrition within a plan population at a given coverage end date.

The defined time interval during which a member's coverage, authorization, or benefit remains active before its scheduled end date, or the duration of a termination processing window. Used in member enrollment and utilization management to define the effective span of terminated benefits.