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Candid Data SharePatients & Payers

export_patient_insurance_history

Patient insurance coverage history with primary, secondary, and tertiary coverage details. One row per patient insurance history version: Candid records a new version whenever the patient record or any of the patient’s primary, secondary, or tertiary coverages changes.

Filter on is_latest_record = TRUE for each patient’s current coverage. When a newer version arrives, the previous version’s is_latest_record changes to FALSE and its updated_at advances, so incremental pulls by updated_at pick up the change.

Primary Key: patient_insurance_history_pk

Identifiers

patient_insurance_history_id
BYTES

Unique composite key for the patient insurance history version

patient_insurance_history_pk
STRINGRequired

String version of unique composite key for the patient insurance history version

patient_insurance_history_version
INTEGER

Version number of the patient insurance history record

patient_id
STRING

Unique ID associated with the patient in the Candid system

patient_mrn
STRING

Medical Record Number - the foreign key to map patient to user’s own system

Timestamps

updated_at
TIMESTAMP

Time at which the patient insurance history record was last updated in the database

patient_version_updated_at
TIMESTAMP

Time when the patient version was updated

Organization

organization_id
STRING

User’s unique organization ID in the Candid system

organization_name
STRING

User’s Organization / Company Name

external_organization_id
STRING

Organization’s External ID - the ID that the organization uses to map to their own upstream system

Patient Version

patient_version
INTEGER

Patient record version number

patient_version_updating_user_id
STRING

User ID who updated the patient version

is_patient_deactivated
BOOLEAN

Whether the patient record has been deactivated

patient_last_name
STRING

Patient’s last name

patient_first_name
STRING

Patient’s first name

patient_middle_name
STRING

Patient’s middle name

patient_dob
DATE

Patient’s date of birth

patient_ssn
STRING

Patient’s Social Security Number

patient_email
STRING

Patient’s email address

is_patient_self_pay
BOOLEAN

Whether the patient is self-pay

patient_primary_service_facility_id
STRING

Patient’s primary service facility ID

patient_version_data
JSON

Raw JSON data for the patient version

Coverage - Primary

primary_coverage_id
STRING

Primary coverage ID

primary_coverage_version
INTEGER

Primary coverage version number

primary_coverage_version_updated_at
TIMESTAMP

Time when primary coverage version was updated

primary_coverage_version_updating_user_id
STRING

User ID who updated primary coverage version

is_primary_coverage_deactivated
BOOLEAN

Whether primary coverage has been deactivated

primary_coverage_status
STRING

Status of primary coverage

primary_coverage_relationship
STRING

Relationship to subscriber for primary coverage

is_primary_coverage_verified
BOOLEAN

Whether primary coverage has been verified

primary_coverage_subscriber_last_name
STRING

Primary coverage subscriber’s last name

primary_coverage_subscriber_first_name
STRING

Primary coverage subscriber’s first name

primary_coverage_subscriber_middle_name
STRING

Primary coverage subscriber’s middle name

primary_coverage_member_id
STRING

Primary coverage member ID

primary_coverage_payer_id
STRING

Primary coverage payer ID

primary_coverage_payer_name
STRING

Primary coverage payer name

primary_coverage_group_number
STRING

Primary coverage group number

primary_coverage_payer_plan_group_id
STRING

Primary coverage Payer Plan ID

primary_coverage_payer_plan_group_name
STRING

Primary coverage Payer Plan name

primary_coverage_payer_plan_type
STRING

Primary coverage plan type

primary_coverage_insurance_type_code
STRING

Primary coverage insurance type code

primary_coverage_network_type
STRING

Primary coverage network type

primary_coverage_start_date
DATE

Primary coverage start date

primary_coverage_end_date
DATE

Primary coverage end date

primary_coverage_version_data
JSON

Raw JSON data for primary coverage version

primary_coverage_elig_status
STRING

Primary coverage eligibility check status

primary_coverage_elig_check_date
TIMESTAMP

Date of last eligibility check for primary coverage

primary_coverage_deductible
FLOAT

Primary coverage individual in-network deductible amount

primary_coverage_deductible_remaining
FLOAT

Primary coverage individual in-network deductible remaining

primary_coverage_deductible_met
BOOLEAN

Whether primary coverage individual in-network deductible has been met

primary_coverage_oop_max
FLOAT

Primary coverage individual in-network out-of-pocket maximum

primary_coverage_oop_max_remaining
FLOAT

Primary coverage individual in-network out-of-pocket maximum remaining

primary_coverage_oop_met
BOOLEAN

Whether primary coverage individual in-network out-of-pocket maximum has been met

primary_coverage_copay
FLOAT

Primary coverage in-network copay amount

primary_coverage_coinsurance_pct
FLOAT

Primary coverage in-network coinsurance percentage

primary_coverage_professional_visit_copay
FLOAT

Primary coverage professional visit copay amount

primary_coverage_professional_visit_coinsurance_pct
FLOAT

Primary coverage professional visit coinsurance percentage

primary_coverage_previous_md_visit_copay
FLOAT

Primary coverage previous MD visit copay amount

primary_coverage_previous_treatment_copay
FLOAT

Primary coverage previous treatment copay amount

Coverage - Secondary

secondary_coverage_id
STRING

Secondary coverage ID

secondary_coverage_version
INTEGER

Secondary coverage version number

secondary_coverage_version_updated_at
TIMESTAMP

Time when secondary coverage version was updated

secondary_coverage_version_updating_user_id
STRING

User ID who updated secondary coverage version

is_secondary_coverage_deactivated
BOOLEAN

Whether secondary coverage has been deactivated

secondary_coverage_status
STRING

Status of secondary coverage

secondary_coverage_relationship
STRING

Relationship to subscriber for secondary coverage

is_secondary_coverage_verified
BOOLEAN

Whether secondary coverage has been verified

secondary_coverage_subscriber_last_name
STRING

Secondary coverage subscriber’s last name

secondary_coverage_subscriber_first_name
STRING

Secondary coverage subscriber’s first name

secondary_coverage_subscriber_middle_name
STRING

Secondary coverage subscriber’s middle name

secondary_coverage_member_id
STRING

Secondary coverage member ID

secondary_coverage_payer_id
STRING

Secondary coverage payer ID

secondary_coverage_payer_name
STRING

Secondary coverage payer name

secondary_coverage_group_number
STRING

Secondary coverage group number

secondary_coverage_payer_plan_group_id
STRING

Secondary coverage Payer Plan ID

secondary_coverage_payer_plan_group_name
STRING

Secondary coverage Payer Plan name

secondary_coverage_payer_plan_type
STRING

Secondary coverage plan type

secondary_coverage_insurance_type_code
STRING

Secondary coverage insurance type code

secondary_coverage_network_type
STRING

Secondary coverage network type

secondary_coverage_start_date
DATE

Secondary coverage start date

secondary_coverage_end_date
DATE

Secondary coverage end date

secondary_coverage_version_data
JSON

Raw JSON data for secondary coverage version

secondary_coverage_elig_status
STRING

Secondary coverage eligibility check status

secondary_coverage_elig_check_date
TIMESTAMP

Date of last eligibility check for secondary coverage

secondary_coverage_deductible
FLOAT

Secondary coverage individual in-network deductible amount

secondary_coverage_deductible_remaining
FLOAT

Secondary coverage individual in-network deductible remaining

secondary_coverage_deductible_met
BOOLEAN

Whether secondary coverage individual in-network deductible has been met

secondary_coverage_oop_max
FLOAT

Secondary coverage individual in-network out-of-pocket maximum

secondary_coverage_oop_max_remaining
FLOAT

Secondary coverage individual in-network out-of-pocket maximum remaining

secondary_coverage_oop_met
BOOLEAN

Whether secondary coverage individual in-network out-of-pocket maximum has been met

secondary_coverage_copay
FLOAT

Secondary coverage in-network copay amount

secondary_coverage_coinsurance_pct
FLOAT

Secondary coverage in-network coinsurance percentage

secondary_coverage_professional_visit_copay
FLOAT

Secondary coverage professional visit copay amount

secondary_coverage_professional_visit_coinsurance_pct
FLOAT

Secondary coverage professional visit coinsurance percentage

secondary_coverage_previous_md_visit_copay
FLOAT

Secondary coverage previous MD visit copay amount

secondary_coverage_previous_treatment_copay
FLOAT

Secondary coverage previous treatment copay amount

Coverage - Tertiary

tertiary_coverage_id
STRING

Tertiary coverage ID

tertiary_coverage_version
INTEGER

Tertiary coverage version number

tertiary_coverage_version_updated_at
TIMESTAMP

Time when tertiary coverage version was updated

tertiary_coverage_version_updating_user_id
STRING

User ID who updated tertiary coverage version

is_tertiary_coverage_deactivated
BOOLEAN

Whether tertiary coverage has been deactivated

tertiary_coverage_status
STRING

Status of tertiary coverage

tertiary_coverage_relationship
STRING

Relationship to subscriber for tertiary coverage

is_tertiary_coverage_verified
BOOLEAN

Whether tertiary coverage has been verified

tertiary_coverage_subscriber_last_name
STRING

Tertiary coverage subscriber’s last name

tertiary_coverage_subscriber_first_name
STRING

Tertiary coverage subscriber’s first name

tertiary_coverage_subscriber_middle_name
STRING

Tertiary coverage subscriber’s middle name

tertiary_coverage_member_id
STRING

Tertiary coverage member ID

tertiary_coverage_payer_id
STRING

Tertiary coverage payer ID

tertiary_coverage_payer_name
STRING

Tertiary coverage payer name

tertiary_coverage_group_number
STRING

Tertiary coverage group number

tertiary_coverage_payer_plan_group_id
STRING

Tertiary coverage Payer Plan ID

tertiary_coverage_payer_plan_group_name
STRING

Tertiary coverage Payer Plan name

tertiary_coverage_payer_plan_type
STRING

Tertiary coverage plan type

tertiary_coverage_insurance_type_code
STRING

Tertiary coverage insurance type code

tertiary_coverage_network_type
STRING

Tertiary coverage network type

tertiary_coverage_start_date
DATE

Tertiary coverage start date

tertiary_coverage_end_date
DATE

Tertiary coverage end date

tertiary_coverage_version_data
JSON

Raw JSON data for tertiary coverage version

tertiary_coverage_elig_status
STRING

Tertiary coverage eligibility check status

tertiary_coverage_elig_check_date
TIMESTAMP

Date of last eligibility check for tertiary coverage

tertiary_coverage_deductible
FLOAT

Tertiary coverage individual in-network deductible amount

tertiary_coverage_deductible_remaining
FLOAT

Tertiary coverage individual in-network deductible remaining

tertiary_coverage_deductible_met
BOOLEAN

Whether tertiary coverage individual in-network deductible has been met

tertiary_coverage_oop_max
FLOAT

Tertiary coverage individual in-network out-of-pocket maximum

tertiary_coverage_oop_max_remaining
FLOAT

Tertiary coverage individual in-network out-of-pocket maximum remaining

tertiary_coverage_oop_met
BOOLEAN

Whether tertiary coverage individual in-network out-of-pocket maximum has been met

tertiary_coverage_copay
FLOAT

Tertiary coverage in-network copay amount

tertiary_coverage_coinsurance_pct
FLOAT

Tertiary coverage in-network coinsurance percentage

tertiary_coverage_professional_visit_copay
FLOAT

Tertiary coverage professional visit copay amount

tertiary_coverage_professional_visit_coinsurance_pct
FLOAT

Tertiary coverage professional visit coinsurance percentage

tertiary_coverage_previous_md_visit_copay
FLOAT

Tertiary coverage previous MD visit copay amount

tertiary_coverage_previous_treatment_copay
FLOAT

Tertiary coverage previous treatment copay amount

Other

is_latest_record
BOOLEAN

Whether this is the most recent version of the patient insurance record (TRUE/FALSE)