Policyholder Coverages
File Name: v2_ph_coverages.csv
This file specifies the coverages available for individual policyholders within a plan. Coverages are tied to the insured individual (insured_id) and determine the type of medical services available, such as prescription drugs or outpatient care.
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 | insured_id | String[64] | Unique identifier of the policyholder/insured individual. This ID must match a record in the v2_policyholders.csv file. |
| 3 | coverage_type | Enum ( PRESCRIPTION_DRUGS | DIAGNOSTIC_TESTS | OUTPATIENT_CARE ) | Type of coverage being added to the policyholder (e.g., prescription drugs, diagnostic tests, outpatient care). |
| 4 | direct_billing_enabled | Boolean (string) | Indicates whether the coverage is eligible for direct billing. |
Notes
- Each coverage type is tied to a specific insured individual and defines their eligibility for medical services within the plan.
- Ensure that the
insured_idcorresponds to a valid record in thev2_policyholders.csvfile.
Updated 5 days ago