Maximum Benefit by Disease for Group
File Name: v2_gr_max_benefits_per_disease.csv
This file defines the maximum benefit limits by disease for members of a specific group within a policy/plan.
Structure
The required fields are marked in bold.
| # | Field Name | Type | Description |
|---|---|---|---|
| 1 | insurer_slug | String[64] | Slug of the Payer provided by Osigu. |
| 2 | policy_number | String[32] | Policy/plan number, must match a record included in the v2_policies.csv file. |
| 3 | group_code | String[32] | Group code belonging to the policy, specified in the v2_groups.csv file. |
| 4 | disease_code | String[16] | Disease group code declared in the v2_disease_groups.csv file. |
| 5 | currency_code | String[3] using the ISO 4217 | Currency code in which the maximum amount is expressed. |
| 6 | max_benefit | Decimal(15,5) | Maximum benefit amount for the specified disease. |
Notes
- Use this file to define disease-specific benefit limits at the group level within a policy.
- To avoid processing errors, ensure disease codes match those declared in the
v2_disease_groups.csvfile.
Updated 5 days ago