PatientCustomInsurance

Primary key - Unique identifier for each patient insurance record

Patient reference - Links to Patient table for the patient

Information update date - Date when insurance information was last updated

Parent consent flag - Whether parent/guardian has consented to insurance use

Insurance plan name - Name of the insurance plan

Insurance company name - Name of the insurance company

Company phone - Phone number of the insurance company

Company billing address - Billing address of the insurance company

Insurance name - Full name of the insurance coverage

Policy holder name - Name of the person who holds the insurance policy

Policy holder birth date - Date of birth of the policy holder

Policy holder gender - Gender of the policy holder

Policy holder address - Address of the policy holder

Policy holder phone - Phone number of the policy holder

Relationship to child - Policy holder’s relationship to the patient

Employer name - Name of the policy holder’s employer

Employer address - Address of the policy holder’s employer

Employer phone - Phone number of the policy holder’s employer

Policy for billing - Policy number used for billing purposes

Group number - Insurance group number

Policy end date - Date when the policy coverage ends

Child Health Plus flag - Whether this is a Child Health Plus plan

Medicaid managed care flag - Whether this is a Medicaid managed care plan

Self-funded plan flag - Whether this is a self-funded insurance plan

Medicaid CIN number - Medicaid Client Identification Number

CIN effective start date - Date when CIN becomes effective

CIN effective end date - Date when CIN expires

Creation date - Date when this insurance record was created

Last update date - Date when this record was last updated

Created by user - UserID of the person who created this record

Updated by user - UserID of the person who last updated this record

Deletion date - Date when this record was marked as deleted

Child member ID - Member identification number for the child

Plan regulated flag - Whether the insurance plan is regulated

Insurance plan type - Type or category of the insurance plan

Policy start date - Date when the policy coverage begins

Insurance plan type - Detailed type of insurance plan

Municipality - Municipality or local government area

Insurance status - Current status of the insurance coverage

Six month no changes - Documentation of no changes at six month review

Six month review date - Date of six month insurance review

Six month initials - Initials of reviewer for six month review

Twelve month no changes - Documentation of no changes at twelve month review

Twelve month review date - Date of twelve month insurance review

Twelve month initials - Initials of reviewer for twelve month review

Eighteen month review - Documentation of eighteen month insurance review

Eighteen month review date - Date of eighteen month insurance review

Eighteen month initials - Initials of reviewer for eighteen month review

Twenty-four month review - Documentation of twenty-four month insurance review

Twenty-four month review date - Date of twenty-four month insurance review

Twenty-four month initials - Initials of reviewer for twenty-four month review

Other review - Documentation of other insurance reviews

Other review date - Date of other insurance review

Other review initials - Initials of reviewer for other review

Insurance parent/guardian name - Name of parent or guardian for insurance purposes

Parent/guardian phone - Phone number of parent or guardian

Parent/guardian birth date - Date of birth of parent or guardian

Payment source - Source of payment for services

Secondary insurance name - Name of secondary insurance coverage

Secondary insurance type - Type of secondary insurance

Secondary insurance plan name - Name of secondary insurance plan